Post by jasminder9985 on Mar 15, 2015 5:47:14 GMT
OLANZAPINE (DEPOT)
Jasminder Sandhu
a) Is the medication a typical or atypical antipsychotic?
Olanzapine is an atypical antipsychotic, which is also an anti-manic and mood stabilising agent that demonstrates a broad pharmacological profile across multiple receptor systems. It is available in 3 main forms. An oral tablet, a short acting IM injection, and for this posts purposes a Long acting IM Depot version.
b) Common brand names for Olanzapine?
Zyprexa Relprevv is the common brand name for the Olanzapine depot. The drug name is olanzapine pamoate monohydrate which is alternatively named as olanzapine embonate monohydrate.
c) Normal dose range for Olanzapine (depot)
The normal does range for Olanzapine depot is to start at 210mg or 300mg every 2 weeks (or 405mg every 4 weeks for the first 2 months, then a maintenance dose reduced to 150-300mg every 2 weeks (or 300mg or 405mg every 4 weeks.
d) Common side effects of Olanzapine (depot)
There are quite a number of possible adverse effects with Olanzapine. Some of the common side effects include sedation, anxiety, agitation, EPSE, orthostatic hypotension, tachycardia, blurred vision, mydriasis, constipation, nausea, dry mouth, urinary retention, sexual adverse effects, weight gain and hyperprolactinaemia which may result in galactorhoea, gynaecomastia, amenorrhoea or infertility.
Some of the more infrequent or rare adverse effects include allergic reactions, hyper/hypothermia, neuroleptic malignant syndrome, anaemia, thrombocytopenia, neutropenia, agranulocytosis, VTE, stroke, ECG changes, arrhythmias, cardiac arrest, sudden death, hepatic fibrosis, priapism, systemic lupus erythematosus, seizure, increase blood glucose, dysarthria and dysphagia.
When considering the side effects of Olanzapine it is also important to remember the possibility of Extrapyramidal side effects occurring. The incidence is usually dose related and is usually the lowest with some of the newer agents (at recommended doses). Some of the extrapyramidal side effects include Dystonia, tardive dyskinesia, parkinsonism and akathesia.
e) Contraindications for Olanzapine (depot)
Zyprexa Relprevv is contraindicated for those patients who may have a known hypersensitivity or allergy to any ingredient that is included in the product. Therefore the ingredients and any allergy a patient may have must be considered before administrating the product. Also if a patient is pregnant the prescriber or treating team must be notified as there are limited clinical trials on whether or not Zyprexa Relprevv is safe for pregnant women.
f) Special monitoring and Nursing care requirements.
It is important to note that Zyprexa depot is for deep intramuscular gluteal use only. It should never be administered intravascular or subcutaneously. Also it is important to consider an adverse effect known as post injection syndrome, this comprises of symptoms such as sedation (ranging from mild in severity up to coma) and/or delirium (including confusion agitation, anxiety and other cognitive impairment). Other symptoms include EPSE, dysarthria, ataxia, aggression, dizziness, weakness, hypertension and possible convulsions mostly in overdoses. In most cases the initial signs and symptoms related to this event have appeared within one hour after the injection. Another adverse effect that needs to be considered is olanzapine toxicity.
Therefore as nurses there are some special monitoring and nursing care requirements that need to be followed when administering the olanzapine (depot). It is important to discuss the potential risk with patients each time the depot is administered; also the olanzapine depot should only be administered by appropriately qualified health professionals in a facility that has access to emergency services that can manage an olanzapine overdose.
Also after each injection, patients should be monitored for a minimum of 2 hours and actively monitored for alertness every 30 minutes. Prior to the patient leaving the facility, it should be confirmed that the patient is alert, orientated and absent of any signs and symptoms of an overdose. This two hour observation period should be extended as clinically appropriate for patients who exhibit any potential signs or symptoms of a post-injection syndrome event. For the remainder off the day after the injection, patients should be advised to be vigilant for symptoms of post-injection adverse reactions and should be able to obtain medical assistance if required. They should not drive or operate heavy machinery. If an overdose is suspected at any time, close medical supervision and monitoring should be initiated until examination indicates that signs and symptoms have resolved.
g) Education Requirements for patients/families/carers.
Patients and others involved in their care should be informed about the adverse effects mentioned in the question above and taught to keep a look out for any of the the related signs and symptoms. If they suspect something is not right they should be advised to seek medical attention immediately.
Jasminder Sandhu
a) Is the medication a typical or atypical antipsychotic?
Olanzapine is an atypical antipsychotic, which is also an anti-manic and mood stabilising agent that demonstrates a broad pharmacological profile across multiple receptor systems. It is available in 3 main forms. An oral tablet, a short acting IM injection, and for this posts purposes a Long acting IM Depot version.
b) Common brand names for Olanzapine?
Zyprexa Relprevv is the common brand name for the Olanzapine depot. The drug name is olanzapine pamoate monohydrate which is alternatively named as olanzapine embonate monohydrate.
c) Normal dose range for Olanzapine (depot)
The normal does range for Olanzapine depot is to start at 210mg or 300mg every 2 weeks (or 405mg every 4 weeks for the first 2 months, then a maintenance dose reduced to 150-300mg every 2 weeks (or 300mg or 405mg every 4 weeks.
d) Common side effects of Olanzapine (depot)
There are quite a number of possible adverse effects with Olanzapine. Some of the common side effects include sedation, anxiety, agitation, EPSE, orthostatic hypotension, tachycardia, blurred vision, mydriasis, constipation, nausea, dry mouth, urinary retention, sexual adverse effects, weight gain and hyperprolactinaemia which may result in galactorhoea, gynaecomastia, amenorrhoea or infertility.
Some of the more infrequent or rare adverse effects include allergic reactions, hyper/hypothermia, neuroleptic malignant syndrome, anaemia, thrombocytopenia, neutropenia, agranulocytosis, VTE, stroke, ECG changes, arrhythmias, cardiac arrest, sudden death, hepatic fibrosis, priapism, systemic lupus erythematosus, seizure, increase blood glucose, dysarthria and dysphagia.
When considering the side effects of Olanzapine it is also important to remember the possibility of Extrapyramidal side effects occurring. The incidence is usually dose related and is usually the lowest with some of the newer agents (at recommended doses). Some of the extrapyramidal side effects include Dystonia, tardive dyskinesia, parkinsonism and akathesia.
e) Contraindications for Olanzapine (depot)
Zyprexa Relprevv is contraindicated for those patients who may have a known hypersensitivity or allergy to any ingredient that is included in the product. Therefore the ingredients and any allergy a patient may have must be considered before administrating the product. Also if a patient is pregnant the prescriber or treating team must be notified as there are limited clinical trials on whether or not Zyprexa Relprevv is safe for pregnant women.
f) Special monitoring and Nursing care requirements.
It is important to note that Zyprexa depot is for deep intramuscular gluteal use only. It should never be administered intravascular or subcutaneously. Also it is important to consider an adverse effect known as post injection syndrome, this comprises of symptoms such as sedation (ranging from mild in severity up to coma) and/or delirium (including confusion agitation, anxiety and other cognitive impairment). Other symptoms include EPSE, dysarthria, ataxia, aggression, dizziness, weakness, hypertension and possible convulsions mostly in overdoses. In most cases the initial signs and symptoms related to this event have appeared within one hour after the injection. Another adverse effect that needs to be considered is olanzapine toxicity.
Therefore as nurses there are some special monitoring and nursing care requirements that need to be followed when administering the olanzapine (depot). It is important to discuss the potential risk with patients each time the depot is administered; also the olanzapine depot should only be administered by appropriately qualified health professionals in a facility that has access to emergency services that can manage an olanzapine overdose.
Also after each injection, patients should be monitored for a minimum of 2 hours and actively monitored for alertness every 30 minutes. Prior to the patient leaving the facility, it should be confirmed that the patient is alert, orientated and absent of any signs and symptoms of an overdose. This two hour observation period should be extended as clinically appropriate for patients who exhibit any potential signs or symptoms of a post-injection syndrome event. For the remainder off the day after the injection, patients should be advised to be vigilant for symptoms of post-injection adverse reactions and should be able to obtain medical assistance if required. They should not drive or operate heavy machinery. If an overdose is suspected at any time, close medical supervision and monitoring should be initiated until examination indicates that signs and symptoms have resolved.
g) Education Requirements for patients/families/carers.
Patients and others involved in their care should be informed about the adverse effects mentioned in the question above and taught to keep a look out for any of the the related signs and symptoms. If they suspect something is not right they should be advised to seek medical attention immediately.