Olanzapine

Question 1

Mode of action

Answer 1

Atypical antipsychotic

• antagonist at multiple receptor sites
• particularly serotonin (5-HT), dopamine and histamine

Question 2

Indications

Answer 2

Mild agitation

Question 3

Contras

Answer 3

NIL

Question 4

Precautions

Answer 4

• May be less effective if pt agitation is due to drug intoxication (especially stimulants) or alcohol withdrawal. Benzodiazepines are considered first-line agents in these pt’s

Question 5

Significant interactions

Answer 5

Sedative medications / alcohol

• over sedation due to synergistic effects
• avoid combination where possible

Question 6

Adverse effects

Answer 6

CNS:

• Sedation
• dizziness

Other:
- extrapyramidal symptoms and QT prolongation are unlikely when administered at the approved doses

Question 7

Administration advice

Answer 7

Route of administration:
- Oral ODT dissolved in mouth and then swallowed

Onset of action:
- 15 mins

Duration of action:
- 12 - 24 hrs

Question 8

Pregnancy and breastfeeding

Answer 8

Pregnancy:

• limited evidence
• administer only if benefit outweighs risk

Breastfeeding:
- considered safe to use

Question 9

Special notes

Answer 9

• Pt’s < 16 yrs consult with receiving hospital
• must self administer
• restricted medication

Similar name and presentation to ondansetron
- extra care must be taken prior to administration

Question 10

Agitated Patient

Answer 10

Mild agitation - SAT score +1

Adult
- 10 mg ODT

< 60 kg / frail / elderly / sedating drug / alcohol
- 5 mg ODT

Repeat initial dose after 20 mins if pt remains mildly agitated