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We have it. Until I use it all.
I am using it daily now. The nurses are amazed at how it turns screaming zombies into otherwise pleasant, normal people who want to go home.
We have it. Until I use it all.
I am using it daily now. The nurses are amazed at how it turns screaming zombies into otherwise pleasant, normal people who want to go home.
Question for those using haldol for headaches. It seems many people use it for this purpose. Are you guys using it in place of the typical migraine cocktail which seems to be compazine or Regan, toradol, and Benadryl, or are you using it as 2nd line for resistant headaches?
I hesitate to give haldol after first giving Compazine or Regan given they all block dopamine receptors.
On the same subject, since all 3 meds block dopamine receptors, what gives haldol the "STFU" effect that doesn't seem to occur with the other meds? Perhaps it is due to action on different subtypes of dopamine receptors. Perhaps haldol is just more potent but acts on the same receptors. Or perhaps there is a different I'm not thinking of.
So it doesn't seem odd to give 2 typical antipsychotics back to back? Seems like it would increase the risk of extra-pyramidal and cardiac conduction adverse effects.I typically use it after compazine. Occasionally it’s first line in patients who have done really well with it.
So it doesn't seem odd to give 2 typical antipsychotics back to back? Seems like it would increase the risk of extra-pyramidal and cardiac conduction adverse effects.
Yeah I don't know why this bothers me. I realize it's unlikely to be a big deal. I think I'm going to start adding haldol more for these types of uses. I'm just trying to establish my comfort level before I start throwing it at all my pain and vomiting patients with axis 2 disorders, which is actually like a pretty high percentage of the people I see.The relative risk is probably higher, but the absolute risk is still pretty freaking low.
I mix / match Haldol, Reglan, Compazine, Phenergan all the time in young healthy people who smoke bags of weed / day. I'm much more careful if you are > 60
Yeah I don't know why this bothers me. I realize it's unlikely to be a big deal. I think I'm going to start adding haldol more for these types of uses. I'm just trying to establish my comfort level before I start throwing it at all my pain and vomiting patients with axis 2 disorders, which is actually like a pretty high percentage of the people I see.
I like the indication for its use:
"Audible anything"
Can't wait until droperidol comes back in full force. Knocks out a true migraine in minutes.
I got a "nastygram" email from the regional director who told me I shouldn't use haldol for nausea and abdominal pain in the superfat teenager (who had "fibromyalgia" already).
She called my local director who was like "yeah, that's pretty common actually".
A week later she sent an email out to everyone else about using haldol for CHS and other conditions.
I was left off that email shockingly. I wasn't ever looking for an apology, but to completely avoid me as if I was going to spike the football was pretty comical.
CMG?
Also how did regional director even know / care?
I got a "nastygram" email from the regional director who told me I shouldn't use haldol for nausea and abdominal pain in the superfat teenager (who had "fibromyalgia" already).
She called my local director who was like "yeah, that's pretty common actually".
A week later she sent an email out to everyone else about using haldol for CHS and other conditions.
I was left off that email shockingly. I wasn't ever looking for an apology, but to completely avoid me as if I was going to spike the football was pretty comical.
That’s funny. Did he use it? Did it help?I saw a kid today after an MVC. I saw that I had seen him the year prior for cyclical vomiting syndrome. Apparently I had prescribed him Haldol and noted that he refused to stop smoking weed. I don't even remember prescribing it to him. Too funny. Must've been a super busy shift. Gave a dose in the ER and prescribe PO Haldol for nausea/vomiting.
I hate that argument. As if I would be embarrassed of explaining my clinical reasoning for something I commonly do. “I, as well as many colleagues have been using this medication for years as adjunctive therapy for numerous pain related complaints with significant empirical evidence of benefit. I have utilized it numerous times as an opioid sparing therapy even when patients have a known acutely painful conditions (like kidney stones) with great success. There is also several studies demonstrating its utility for migraines and gastroparesis. My patients are told they are being given an antipsychotic not because I believe they are crazy, but because I believe it is effective for certain pain related complaints.”So I’ve talked about my love of Haldol here especially for the intractable migraines and patients with the triad of chronic pain, psych issues, and strange constellation of chronic symptoms no one can figure out. I don’t use it often but I use it for this people. And my favorite attending told me the other day to “be careful when using it” not because of the QT prolongation but “because how will it look if there’s a bad outcome and the case goes to court and you treated a patient’a symptoms with an anti psychotic?” Thoughts on this?
Well, during the great drug shortage of early 2010s, the FDA and multiple P&T committees came out in support of using haldol as they were out of zofran, reglan, compazine, and other drugs.“because how will it look if there’s a bad outcome and the case goes to court and you treated a patient’a symptoms with an anti psychotic?” Thoughts on this?
So I’ve talked about my love of Haldol here especially for the intractable migraines and patients with the triad of chronic pain, psych issues, and strange constellation of chronic symptoms no one can figure out. I don’t use it often but I use it for this people. And my favorite attending told me the other day to “be careful when using it” not because of the QT prolongation but “because how will it look if there’s a bad outcome and the case goes to court and you treated a patient’a symptoms with an anti psychotic?” Thoughts on this?
I asked our pharmacist about getting droperidol and apparently the Hospital's provider doesn't have droperidol to buy.