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𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊

27-10-2022

18:08

another haloperidol thread 😃 this fresh pro-con debate on the use of IV haloperidol is important reading (even for folks not working in the emergency department). (is there any neuroactive medication that people don't have passionate opinions about? 🤣)

from the ICU perspective, the recent AID-ICU trial shows that IV haloperidol is safe in the ICU. of course, this *assumes* that it's used wisely (with attention to electrolytes and QT) (hint: when in doubt, give IV magnesium along with the haloperidol)

as @SkylerLentz et al. discuss, haloperidol is generally preferred over benzodiazepines for agitation in the ICU. as a general rule of thumb, *any* time you're tempted to use benzodiazepines in the ICU - consider whether haloperidol might be a better option. benzos are a trap:

IV olanzapine may be an attractive alternative to IV haloperidol, with many of the same indications. advantages: no risk of QT prolongation, reduced rate of extrapyramidal sx disadvantages: higher cost, not widely available (often not stocked in ICU)

and finally a brief reminder that haloperidol and droperidol are very similar (especially when given IV, if you use a sufficient dose of haloperidol) so if you love droperidol (which it seems like everyone does), it's only logical to share a little of that love with haloperidol



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