NEURO: ANTIPSYCHOTICS, 1ST GENERATION TYPICAL - HALOPERIDOL

Question 1

ANP(T) HALOPERIDOL: INDICATIONS

Answer 1

• Urgent tx of psychomotor agitation = dangerous/violent behaviour
• Schizophrenia
• Bipolar disorder
• Nausea and vomiting

Question 2

ANP(T) HALOPERIDOL: MOA

Answer 2

• Block post synaptic Dopamine D2 receptors

Question 3

ANP(T) HALOPERIDOL: ADVERSE EFFECTS

Answer 3

• Extrapyramidal effects = movement abnormalities that arise due to D2 blockade in the nigrostriatal pathway
  (acute dystonic rxns - involuntary parkinsonian movements, muscle spasms; Akathisia - inner restlessness; Neuroleptic malignant syndrome)
• These occur early in treatment
• Tardive Dyskinesia = late adverse effect
• Drowsiness
• Hypotension
• QT-interval prolongation
• Consequent arrhythmias
• Erectile dysfunction
• Hyperprolactinaemia

Question 4

ANP(T) HALOPERIDOL: WARNINGS

Answer 4

• Elderly who are sensitive to antipsychotics
• Dementia patients
• Parkinsons = extrapyramidal effect

Question 5

ANP(T) HALOPERIDOL: IMPORTANT INTERACTIONS

Answer 5

• Drugs that prolong the QT interval (amiodarone, macroclides)

Question 6

ANP(T) HALOPERIDOL: OTHER EXAMPLES

Answer 6

• Chlorpromazine

- Prochlorperazine