Haloperidol use may lead to the development of symptoms that resemble Parkinson's disease, but that are not caused by Parkinson's. These symptoms may include a taut or mask-like expression on the face, drooling, tremors, pill-rolling motions in the hands, cogwheel rigidity (abnormal rigidity in muscles, characterized by jerky movements when the muscle is passively stretched), and a shuffling gait. Taking the anti-Parkinson drugs benztropine mesylate or trihexyphenidyl hydrochloride along with haloperidol help to control these symptoms. Medication to control Parkinsonian-like symptoms may have to be continued after haloperidol is stopped. This is due to different rates of elimination of these drugs from the body.
The intravenous route is not FDA approved and is generally not recommended except when no other alternatives are available. Intravenous administration appears to be associated with a higher risk of QT prolongation and torsade de pointes (TdP) than other forms of administration. The manufacturer recommends ECG monitoring for QT prolongation and arrhythmias if IV administration is required. A dose in the range of 1 to 5 mg IV has been suggested, with the dose being repeated at 30 to 60 minute intervals, if needed. A maximum IV dose has not been established. The lowest effective dose should be used in conjunction with conversion to oral therapy as soon as possible.
I’m on my second round of being a caretaker of an advanced Alzheimer’s patient. My father has passed on and I am now taking care of his sister, my aunt, who is eighty six. My advice, through experience, give them food when they want it and pick your battles. It is easier to agree than to argue. If you have to tell them they need to go to bed because we have to get up for church in the morning, do it. Every day could be Sunday here. There are times where they have had extreme clarity and times they have no clue who I was. My aunt always wants to go “home”, thousands of miles from my house where she now lives. We have used the term vacation as the reason she is here many times. As well as Alzheimer’s, she is basically a walking, or should I say shuffling, miracle as MRI’s of her spine show that her back is pretty well burnt toast. She is in pain, but yet when I take her to the doctor she states she is not. I have used video to show the doctor that what I am saying about her pain is true. On video she will go from a pain level of 10 to zero in a matter of minutes, but she is in pain. The video was the only way to convince the doctor, besides demanding and MRI. We have “baby” alarms on the doors and when she figured out how to knock the batteries out of them we put on the “baby” door knob covers – these have worked. We take the knobs off the stove at night to keep her from blowing us up as well, and the sliding glass door has a pair of vice grips along the track at the top to keep her in. Double keyed dead bolts where a key is needed to open from the inside and out will also keep a loved one indoors during the night. My opinion, and my opinion only, is that it is my job to take care of her, I refuse to fight and try to find humor in the repetition or demands – it is pretty easy to redirect someone in her condition to change the subject, and it often works. The fact is… she is dying a slow death and I want to make her as comfortable as possible. If the house is Auntie proofed, she can’t hurt herself or get out in the middle of the night and I can get my sleep too. I would much rather have her here with me than in a home. Most homes I have visited I wouldn’t let my dog live in. God bless you all for all you do, you are earning you wings. Good luck.