Psychiatric Medications Q 57
Miranda, a psychiatric client is to be discharged with orders for haloperidol (Haldol) therapy. When developing a teaching plan for discharge, the nurse should include cautioning the client against:
A. Driving at night.
B. Staying in the sun.
C. Ingesting wines and cheeses.
D. Taking medications containing aspirin.
Correct Answer: B. Staying in the sun
Haldol causes photosensitivity. Severe sunburn can occur on exposure to the sun. Photosensitivity is an adverse effect of many drugs, characteristically producing skin lesions in the areas exposed to light, which includes the face, “V” area of the neck, extensor surfaces of forearms, and dorsa of hands with sparing of submental and retroauricular areas. Two major mechanisms mediating drug-induced photosensitivity reactions are phototoxic and photoallergic responses.
Option A: Haloperidol does not cause optic side effects. Due to the blockade of the dopamine pathway in the brain, typical antipsychotic medications such as haloperidol have correlations with extrapyramidal side effects. Since the drug can cause several side effects and related to several toxicities after initiation, the healthcare workers must be familiar with its pharmacology, sign symptoms of toxicity, and management of adverse effects. They must monitor their side effects and toxicities. A proper history and physical examination are necessary before the initiation of haloperidol in any patient.
Option C: Toxicities are the exaggerated symptoms of known pharmacologic effects and known adverse reactions. The most prominent toxicities of haloperidol are 1) severe extrapyramidal symptoms, hypotension, sedation. The patient may appear comatose with severe respiratory depression or shock from hypotension. The extrapyramidal symptoms are muscular weakness or rigidity, a generalized or localized tremor that may be characterized by the akinetic or agitations types of movements, respectively. Haloperidol overdose is also associated with ECG changes known as torsade de pointes, which may cause arrhythmia or cardiac arrest.
Option D: Haloperidol is contraindicated if there is documented hypersensitivity to this drug, in Parkinson’s disease, dementia with Lewy body, comatose patient, in any condition with the depressed central nervous system (CNS). Since many drugs (barbiturates, benzodiazepines, and opioids) can cause depression to CNS, concurrent use of haloperidol should be avoided or used with great caution.