Myung In Haloperidol Overdosage

Manifestations: In general, the symptoms of overdosage would be an exaggeration of known pharmacologic effects and adverse reactions, the most prominent of which would be severe extrapyramidal reactions, hypotension, or sedation. The extrapyramidal reactions would be manifested by muscular weakness or rigidity and a generalized or localized tremor. Hypertension rather than hypotension occurred. The patient may appear comatose with respiratory depression and hypotension, which could be severe enough to produce a shock-like state. The risk of ventricular arrhythmias, possibly associated with QT-prolongation should be considered.
Treatment: Since there is no specific antidote, treatment is primarily symptomatic and supportive. Activated charcoal should be administered after gastric lavage and emesis. A patient airway must be established by use of an oropharyngeal airway or endotracheal tube on in prolonged cases of coma, by tracheostomy. Respiratory depression may be counteracted by artificial respiration ECG and vital signs should be monitored and monitoring should continue until the ECG is normal. Severe arrhythmias should be treated with appropriate antiarrhythmic measures. Hypotension and circulatory collapse may be counteracted by use of intravenous fluids, plasma, or concentrated albumin, and vasopressor agents such as dopamine, norepinephrine. Epinephrine should not be used since it may cause profound hypotension in the presence of haloperidol. In case of severe extrapyramidal reactions, antiparkinson (benztropine mesylate 1-2 mg IM or IV) medication should be administered.