Caution is advised in patients suffering from epilepsy and in conditions predisposing to convulsions such as alcohol withdrawal and brain damage. It has been reported that seizures can be triggered by haloperidol. Because QT-interval prolongation may occur by taking this agent, it should be used with caution in patients with QT-prolongation conditions (QT syndrome, hypokalemia, prolonged QT-interval). General Precautions: Sudden and unexpected deaths have been reported in association with the administration of antipsychotic drug including haloperidol. or patients with a history of seizure (haloperidol may lower the convulsive threshold) Patients with hyperthyroidism or hypothyroidism (extrapyramidal reactions may occur) Patients receiving anticoagulants Hypersensitivity or with a history of hypersensitivity to drugs Infant-child Patients with physical damage accompanied with dehydration and malnutririon Depression Patients with QT syndrome and hypokalaemia, patients receiving drugs to prolong the QT interval patients with prolactin-dependent tumor Patient with narrow angle glaucoma Patient with severe myasthenia gravis Patient with prostatomegaly The elderly. Patients with liver disease and renal failure Patients with phaeochromocytoma, cardiovascular disease, hypotension or conditions predisposing to this symptom (transient lowering of the blood pressure may occur) Patients with convulsive disease such as seizure etc. In case of severe extrapyramidal reactions, antiparkinson (benztropine mesylate 1-2 mg IM or IV) medication should be administered. Epinephrine should not be used since it may cause profound hypotension in the presence of haloperidol. Hypotension and circulatory collapse may be counteracted by use of intravenous fluids, plasma, or concentrated albumin, and vasopressor agents such as dopamine, norepinephrine. Severe arrhythmias should be treated with appropriate antiarrhythmic measures. Respiratory depression may be counteracted by artificial respiration ECG and vital signs should be monitored and monitoring should continue until the ECG is normal. A patient airway must be established by use of an oropharyngeal airway or endotracheal tube on in prolonged cases of coma, by tracheostomy. Activated charcoal should be administered after gastric lavage and emesis. Treatment: Since there is no specific antidote, treatment is primarily symptomatic and supportive. The risk of ventricular arrhythmias, possibly associated with QT-prolongation should be considered. The patient may appear comatose with respiratory depression and hypotension, which could be severe enough to produce a shock-like state. Hypertension rather than hypotension occurred. The extrapyramidal reactions would be manifested by muscular weakness or rigidity and a generalized or localized tremor. 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.
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