Psych Flashcards
Haloperidol indications
Emergency sedation of severely agitated or delirious
Used in ICU to treat confusion and hallucinations
Haloperidol MOA
First gen (typical) antipsychotic
Post-synaptic Mesolimbic dopamine receptor antagonist. Depressed release of hypothalamic and hypophyseal (anterior pituitary) hormones leading to depression in reticular activating system (basal metabolism, body temp, wakefulness, Vasomotor tone, emesis sites).
Haloperidol dosages
5-10mg IM
2-5mg IV, titrate to effect
Adjunct to standard antiemetics: 0.5-1.0mg PO/SC/IV
Haloperidol contraindications and side effects
Hypersensitivity, Parkinson’s, severe CNS depression
Prolonged QT, hypotension, neuroleptic malignant syndrome
Haldol pharmacokinetics
Onset 30-60min
Duration 4-6hrs
Lorazepam MOA
Allosterically binds to postsynaptic GABA-A receptors to enhance inhibitory effect of GABA by increasing neuronal membrane permeability to Cl- leading to hyperpolarization/less excitable state.
Lorazepam contraindications and adverse effects
- Hypersensitivity (or to propylene/polyethylene glycols/PEGs- in some Rx, bath/body products)
- Neo/infants
- renal fail
- resp impaired, sleep apnea
- narrow angle glaucoma
- myasthenia gravis
Caution:
- 3rd trimester (risk of tetragenicity and floppy infant syndrome, excreted in breast milk)
<3YO or elderly
CNS, pulmonary or hepatic impairment
Drugs/alcohol abuse
Adverse effects:
CNS impairment
Weak/fatigue
Respiratory depression
Extrapyramidal reactions, seizures
Hypotension
Increased liver transaminases and ALP
etc
DRUG INTERACTIONS (ie Metoclopramide) EXIST
Lorazepam indications and dosages
Anxiety: 0.5-3.0mg IM//IV/PO
Status epilepticus: 4.0mg IV push (2mg/min) repeat once at 3-5min.
*IM not recommended for seizure (too slow absorption)
Procedural Sedation:
- loading dose 0.02-0.04mg/kg (max. 4mg)
- maintenance 0.01-0.1mg/kg/hr (max.10mg/hr)
Adjunct to conventional antiemetics:
0.5-1.0mg PO/IV/SL
Lorazepam pharmacokinetics
Onset: 1-3min IV
Duration: <8hrs
