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OlanzapineAka: Zyprexa

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  1. Class
    1. Atypical Antipsychotic (Second Generation agent)
    2. Neuroleptic
    3. Thienobenzodiazepine
  2. Indications
    1. Schizophrenia
    2. Acute mania phase of Bipolar Disorder
    3. No longer recommended for Psychosis in Dementia
      1. Higher risk of CVA and overall mortality in elderly
  3. Dosing
    1. Adults
      1. Start: 5 to 10 mg PO qd
      2. Increase in 5 mg increments weekly as tolerated
      3. Maximum: 20 mg/day
    2. Elderly
      1. Initial: 1.25 to 2.5 mg PO qd
      2. Titrate up as tolerated (watch for hypotension)
      3. Maximum: 10 mg/day
  4. Adverse effects
    1. Weight gain (4 kg)
    2. Sedation
    3. Orthostatic Hypotension
    4. Seizures (nearly 1% of patients)
    5. Overall higher mortality in elderly
    6. Hyperglycemia
      1. Increased risk of Diabetes Mellitus
      2. Koro (2002) BMJ 325:243
    7. Hyperlipidemia
      1. Koro (2002) Arch Gen Psychiatry 59:1021
  5. Drug Interactions
    1. Increase Antipsychotic levels (toxicity risk): Monitor for toxicity
      1. Ciprofloxacin
      2. Fluvoxamine
    2. Decrease Antipsychotic levels (lower efficacy)
      1. Carbamazepine
      2. Phenytoin
      3. Nicotine
      4. Rifampin
      5. Omeprazole
  6. Monitoring
    1. See Antipsychotic

olanzapine (C0171023)

Definition (NCI)A synthetic derivative of thienobenzodiazepine with antipsychotic properties. As a selective monoaminergic antagonist, olanzapine binds with high affinity binding to the following receptors: serotoninergic, dopaminergic, muscarinic M1-5, histamine H1, and alpha-1-adrenergic receptors; it binds weakly to gamma-aminobutyric acid type A, benzodiazepine, and beta-adrenergic receptors. Although its exact mechanism of action in schizophrenia is unknown, it has been proposed that olanzapine's antipsychotic activity is mediated through a combination of dopamine and serotonin type 2 antagonism.
Definition (PDQ)A synthetic derivative of thienobenzodiazepine with antipsychotic properties. As a selective monoaminergic antagonist, olanzapine binds with high affinity binding to the following receptors: serotonin, dopamine, muscarinic M1-5, histamine H1, and alpha1-adrenergic receptors; it binds weakly to gamma-aminobutyric acid type A, benzodiazepine, and beta-adrenergic receptors. Although its exact mechanism of action in schizophrenia is unknown, it has been proposed that olanzapine's antipsychotic activity is mediated through a combination of dopamine and serotonin type 2 antagonism. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=449664&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=449664&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C47639" NCI Thesaurus)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC076029
Englisholanzapine, OLANZAPINE PREPARATION
Spanisholanzapina
Parent ConceptsAntipsychotic Agents (C0040615), Pirenzepine (C0031978), [CN709] ANTIPSYCHOTICS, OTHER (C0973508), Dibenzoxazepine derivative antipsychotic agent (C0304389), Atypical antipsychotic (C1276996), Mood stabilizing drug (C1276998), Drug allergen (C1320237), Non-phenothiazines/ Atypicals (C1579416)
SourcesCSP, LNC, MSH, MTHSPL, NCI, NDFRT, PDQ, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Zyprexa (C0527258)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC076029
EnglishEli Lilly brand of olanzapine, Lilly brand of olanzapine, Zyprexa
SourcesMSH, NCI, PDQ, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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