ANTIPSYCHOTICS Flashcards
MOA of Olanzapine
Antagonist at D 1,2 and 4
Antagonist at H1, M2 and alpha-1
Inverse agonist at 5HT2 receptors
Class of olanzapine
Thienobenzodiazepine atypical antipsychotic
Indications for olanzapine
Schizophrenia
Bipolar disorder
Agitations associated with schizophrenia and bipolar disorder
Chemotherapy induced nausea or vomiting
Dosing for oral olanzapine
Mania and Bipolar disorder
5-10mg initially, max of 20mg, increase at more than weekly intervals
Chemotherapy induced nausea or vomiting in combination with 5HT3 antagonist and Dexamethasone
5-10mg PO daily for 3 days
Dosing for olanzapine IM
Agitation associated with schizophrenia and bipolar disorder
Initially 2.5mg-10mg then 2nd dose after 2 hours then 3 rd dose
Maximum of 30mg per day
Extended release Dosing for olanzapine based on oral doses
Oral dosage 10 mg/day: 210 mg IM every 2 weeks or 405 mg IM every 4 weeks for 1st 8 weeks, then 150 mg every 2 weeks or 300 mg every 4 weeks
Oral dosage 15 mg/day: 300 mg IM every 2 weeks for 1st 8 weeks, then 210 mg every 2 weeks or 405 mg every 4 weeks
Oral dosage 20 mg/day: 300 mg IM every 2 weeks for 1st 8 weeks, then 300 mg every 2 weeks
Side effects of Olanzapine
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).
Elevated alanine aminotransferase (ALT) level
Orthostatic hypotension
Weight gain
Hypertiglyceridemia
Hypercholesterolemia
Hyperglycemia
Dizziness
Somnolence
Extrapyramidal symptoms
Xerostemia
Weakness
Insomnia
Considerations for olanzapine
Associated with higher incidence of weight than other atypical antipsychotics
No dose adjustment needed in renal impairment
Contraindications of Olanzapine
Acute myocardial infarction
bradycardia .
recent heart surgery
. severe hypotension .
sick sinus syndrome . unstable angina
Cautions for Olanzapine
Bone-marrow depression
. hypereosinophilic disorders .
low leucocyte count
. low neutrophil count
. myeloproliferative disease . paralytic ileus
