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Olanzapine

Aka: Olanzapine, Zyprexa
  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 325:243-5
    7. Hyperlipidemia
      1. Koro (2002) Arch Gen Psychiatry 59:1021-6
  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

Zyprexa (C0527258)

Definition (CHV) a kind of psychiatry drug
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C076029
English Zyprexa, zyprexa, ZyPREXA, Eli Lilly brand of olanzapine, Lilly brand of olanzapine
Sources
Derived from the NIH UMLS (Unified Medical Language System)


olanzapine (C0171023)

Definition (NCI) A synthetic derivative of thienobenzodiazepine with antipsychotic, antinausea, and antiemetic activities. 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. The antinausea and antiemetic effects of this agent appear to be due to the blockade of 5-HT2 and 5-HT3 receptors for serotonin. Although its exact mechanism of action in schizophrenia is unknown, it has been proposed that olanzapine's antipsychotic activity is mediated through antagonism to dopamine D2 receptors with rapid ligand-receptor dissociation kinetics that help to minimize extrapyramidal symptoms (EPS). Olanzapine may also stimulate appetite.
Definition (CHV) a drug used to treat schizophrenia
Definition (NCI) A drug used to treat certain mental disorders. It is also being studied in the treatment of nausea and vomiting caused by some cancer treatments. It is a type of antipsychotic and a type of monoamine antagonist.
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)
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C076029
SnomedCT 108441004, 386849001
English 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno(2,3-b)(1,5)benzodiazepine, olanzapine, 2-Methyl-4-(4-methyl-1-piperazinyl)-10H-thieno(2,3-b)(1,5)benzodiazepine, olanzapine (medication), olanzapine [Chemical/Ingredient], OLANZAPINE, olanzapine (Zyprexa), OLANZapine, Olanzapine, Olanzapine (product), Olanzapine (substance)
Spanish olanzapina (producto), olanzapina (sustancia), olanzapina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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