Post by edgar on Feb 23, 2015 8:50:55 GMT
Olanzapine (oral/wafer)
a) Is the medication a typical/atypical antipsychotic? Is the medication an SSRI/SNRI antidepressant?
Olanzapine is an atypical thienobenzodiazepine, second-generation antipsychotic agent which is believed to act by blocking dopamine (D2) in the brain, the renin-angiotensin system (RAS), cholinergic, muscarinic (acetylcholine), serotonergic (5HT2), α1-adrenergic and histaminergic (H1) receptors. As an atypical agent, it produces fewer extrapyramidal effects and is indicated for treatment and maintenance of psychosis (excess transmission of dopamine), including schizophrenia; and acute mania/depression, including bipolar 1 disorder; dementia, including Alzheimer's disease; agitation; and delirium. Olanzapine is available in the form of tablets; wafers or orally disintegrating tablets; and powder for injection. Although Olanzapine can be used to treat depression, it is neither a selective serotonin reuptake inhibitors (SSRI) nor a serotonin and norepinephrine reuptake inhibitors/SNRI).
b) Common brand names
The most common brand name for Olanzapine is Zyprexa
c) Normal dose range
Initial daily oral dose of 5 -10mg for schizophrenia, incrementally increased to 20mg as needed; and 10 – 15mg daily oral incrementally increased for acute mania with bipolar disorder, or 5 -10mg daily IM, incrementally increased to 30mg if patient is agitated.
d) Common side effects
Olanzapine has central nervous system side effects, including somnolence, dizziness, nervousness, headache, akathisia, personality disorders, tardive dyskinesia, neuroleptic malignant syndrome, and tremors; cardiovascular system side effects, including orthostatic hypotension, peripheral oedema, and tachycardia; gastrointestinal system side effects, including constipation, abdominal pain, dry mouth, dyspepsia, and vomiting; respiratory system side effects, including cough, and pharyngitis; and whole body side effects, including fever, joint pain, and metabolic side effects such as dyslipidemia, hyperglycemia, weight gain, glucose intolerance, and insulin resistance.
e) Contraindications
Olanzapine is contraindicated for people with allergy or hypersensitivity to olanzapine, myeloproliferative disorders, severe CNS depression, elderly, debilitated, cardiovascular disease, cerebrovascular disease, dehydration, seizure disorders, Alzheimer's disease, prostate enlargement, glaucoma, diabetic, cancer, and pregnant patients.
f) Special monitoring/nursing care requirements
- Monitor for adverse drug-drug interactions, such as increased risk of orthostatic hypotension with antihypertensives, and benzodiazepines; decreased effectiveness with rifampin, omeprazole, carbamazepine, and smoking; and increased risk of toxicity with fluvoxamine
- Monitor blood pressure regularly throughout therapy, especially for patients aged 65 years or over.
- Monitor serum cholesterol and triglycerides during therapy, and exercise caution if patients have conditions such as diabetes, pregnancy, prostatic hypertrophy, glaucoma, kidney/liver impairment, bone marrow depression, history of seizures, and cardiovascular disease.
- Ensure patient remains recumbent after injection to prevent postural hypotension, and monitor vital signs should be monitored after intramuscular (IM) administration
- Handle wafers carefully as they are very fragile, and should not be used in patients with phenylketonuria (PTK) because they contain aspartame. They should be placed on the tongue directly from the blister pack, and should not be dissolved in beverages.
- Check labels carefully to prevent confusing Zyprexa (olanzapine) with zyrtec (cetirizine).
- Monitor elderly patients for dehydration as the CNS effects of the drug lead to sedation and decreased sensation.
- Monitor for urinary retention as this is one of the anticholinergic effects of the drug. The patient should be encouraged to void before taking the drug.
g) Education requirements for patients/families/carers
- Take Olanzapine only as prescribed, and do not change dose without doctor’s permission.
- Handle wafers carefully as they are very fragile, and should be placed on the tongue directly from the blister pack, and should not be dissolved in beverages.
- Olanzapine should not be taken during pregnancy, and the doctor should be informed if planning to or falling pregnant.
- Report side effects, such as drowsiness, dizziness, sedation, seizures, increased salivation; constipation; fast heart rate; lethargy, weakness, fever, sore throat, malaise, mouth ulcers, and flulike symptoms.
- Avoid doing tasks that require concentration, including driving.
a) Is the medication a typical/atypical antipsychotic? Is the medication an SSRI/SNRI antidepressant?
Olanzapine is an atypical thienobenzodiazepine, second-generation antipsychotic agent which is believed to act by blocking dopamine (D2) in the brain, the renin-angiotensin system (RAS), cholinergic, muscarinic (acetylcholine), serotonergic (5HT2), α1-adrenergic and histaminergic (H1) receptors. As an atypical agent, it produces fewer extrapyramidal effects and is indicated for treatment and maintenance of psychosis (excess transmission of dopamine), including schizophrenia; and acute mania/depression, including bipolar 1 disorder; dementia, including Alzheimer's disease; agitation; and delirium. Olanzapine is available in the form of tablets; wafers or orally disintegrating tablets; and powder for injection. Although Olanzapine can be used to treat depression, it is neither a selective serotonin reuptake inhibitors (SSRI) nor a serotonin and norepinephrine reuptake inhibitors/SNRI).
b) Common brand names
The most common brand name for Olanzapine is Zyprexa
c) Normal dose range
Initial daily oral dose of 5 -10mg for schizophrenia, incrementally increased to 20mg as needed; and 10 – 15mg daily oral incrementally increased for acute mania with bipolar disorder, or 5 -10mg daily IM, incrementally increased to 30mg if patient is agitated.
d) Common side effects
Olanzapine has central nervous system side effects, including somnolence, dizziness, nervousness, headache, akathisia, personality disorders, tardive dyskinesia, neuroleptic malignant syndrome, and tremors; cardiovascular system side effects, including orthostatic hypotension, peripheral oedema, and tachycardia; gastrointestinal system side effects, including constipation, abdominal pain, dry mouth, dyspepsia, and vomiting; respiratory system side effects, including cough, and pharyngitis; and whole body side effects, including fever, joint pain, and metabolic side effects such as dyslipidemia, hyperglycemia, weight gain, glucose intolerance, and insulin resistance.
e) Contraindications
Olanzapine is contraindicated for people with allergy or hypersensitivity to olanzapine, myeloproliferative disorders, severe CNS depression, elderly, debilitated, cardiovascular disease, cerebrovascular disease, dehydration, seizure disorders, Alzheimer's disease, prostate enlargement, glaucoma, diabetic, cancer, and pregnant patients.
f) Special monitoring/nursing care requirements
- Monitor for adverse drug-drug interactions, such as increased risk of orthostatic hypotension with antihypertensives, and benzodiazepines; decreased effectiveness with rifampin, omeprazole, carbamazepine, and smoking; and increased risk of toxicity with fluvoxamine
- Monitor blood pressure regularly throughout therapy, especially for patients aged 65 years or over.
- Monitor serum cholesterol and triglycerides during therapy, and exercise caution if patients have conditions such as diabetes, pregnancy, prostatic hypertrophy, glaucoma, kidney/liver impairment, bone marrow depression, history of seizures, and cardiovascular disease.
- Ensure patient remains recumbent after injection to prevent postural hypotension, and monitor vital signs should be monitored after intramuscular (IM) administration
- Handle wafers carefully as they are very fragile, and should not be used in patients with phenylketonuria (PTK) because they contain aspartame. They should be placed on the tongue directly from the blister pack, and should not be dissolved in beverages.
- Check labels carefully to prevent confusing Zyprexa (olanzapine) with zyrtec (cetirizine).
- Monitor elderly patients for dehydration as the CNS effects of the drug lead to sedation and decreased sensation.
- Monitor for urinary retention as this is one of the anticholinergic effects of the drug. The patient should be encouraged to void before taking the drug.
g) Education requirements for patients/families/carers
- Take Olanzapine only as prescribed, and do not change dose without doctor’s permission.
- Handle wafers carefully as they are very fragile, and should be placed on the tongue directly from the blister pack, and should not be dissolved in beverages.
- Olanzapine should not be taken during pregnancy, and the doctor should be informed if planning to or falling pregnant.
- Report side effects, such as drowsiness, dizziness, sedation, seizures, increased salivation; constipation; fast heart rate; lethargy, weakness, fever, sore throat, malaise, mouth ulcers, and flulike symptoms.
- Avoid doing tasks that require concentration, including driving.