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Related Experiment Videos

Haloperidol-induced torsade de pointes.

J M O'Brien1, R P Rockwood, K I Suh

  • 1Department of Pharmacy, Grant Medical Center, Columbus, OH 43215, USA. jobrien@ohiohealth.com

The Annals of Pharmacotherapy
|October 26, 1999
PubMed
Summary

High-dose intravenous haloperidol can cause torsade de pointes, a dangerous heart arrhythmia. This case highlights the need for caution when administering haloperidol, especially in high doses, to manage agitation.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Critical Care Medicine

Background:

  • Intravenous haloperidol is frequently used for severe agitation and delirium.
  • Torsade de pointes (TdP) is a rare but life-threatening ventricular arrhythmia associated with QT interval prolongation.

Observation:

  • A case of TdP occurred in a 41-year-old woman 55 minutes after an 80 mg dose of intravenous haloperidol.
  • The patient presented with a prolonged QTc interval of 610 milliseconds.
  • The arrhythmia was successfully managed with intravenous magnesium sulfate.

Findings:

  • High-dose intravenous haloperidol administration was linked to QT interval prolongation and TdP.
  • The patient received a subsequent dose of haloperidol without recurrence of arrhythmia.
  • Discontinuation of haloperidol led to the resolution of arrhythmias.

Implications:

  • Clinicians must be aware of the potential for haloperidol to induce TdP, even in patients without predisposing factors.
  • Careful monitoring of QT intervals is recommended during intravenous haloperidol therapy, particularly with high doses.
  • This case underscores the importance of risk-benefit assessment when using haloperidol for agitation in critical care settings.

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