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QuetiapineAka: Seroquel

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  1. Class
    1. Atypical Antipsychotic (Second Generation agent)
    2. Neuroleptic
    3. Dibenzothiazepine Antipsychotic
  2. Indications
    1. Schizophrenia
    2. Psychosis in Dementia
    3. Mania (not FDA approved)
    4. Bipolar Disorder (not FDA approved)
    5. Autism (not FDA approved)
    6. Insomnia (not FDA approved)
  3. Dosing
    1. Adults
      1. Initial: 25 mg PO bid-tid
      2. Increase in 25-50 mg/day increments
      3. Target: 300-400 mg/day divided bid-tid
      4. Maximum dose: 750 mg/day
    2. Elderly
      1. Initial dose: 12.5 mg PO qhs
      2. Titrate up every few days (caution due to Sedation)
  4. Adverse Effects
    1. Sedation
    2. Headache
    3. Orthostatic Hypotension
    4. Cataract formation
  5. Drug Interactions
    1. Increase Antipsychotic levels (toxicity risk): Monitor for toxicity
      1. Clarithromycin
      2. Erythromycin
      3. Grapefruit juice
      4. Fluconazole
      5. Itraconazole
      6. Ketoconazole
      7. Quinidine
    2. Decrease Antipsychotic levels (lower efficacy)
      1. Barbiturates
      2. Carbamazepine
      3. Phenytoin
      4. Rifampin
      5. Theophylline
    3. Other effects
      1. Avoid concurrent use of other medications prolonging QT Interval
        1. See Prolonged QT Interval due to Medication
  6. Monitoring
    1. See Antipsychotic
    2. Screen for Cataract formation every 6 months
    3. Consider EKG, electrolyte and Magnesium monitoring due to QT Interval prolongation risk
  7. Pharmacokinetics
    1. Metabolized by Cytochrome P450 3A4

quetiapine (C0123091)

Definition (NCI)A dibenzothiazepine derivative with antipsychotic property. Quetiapine fumarate antagonizes serotonin activity mediated by 5-HT 1A and 5-HT2 receptors. With a lower affinity, this agent also reversibly binds to dopamine D1 and D2 receptors in the mesolimbic and mesocortical areas of the brain leading to decreased psychotic effects, such as hallucinations and delusions. In addition, quetiapine also binds to other alpha-1, alpha-2 adrenergic and histamine H1 receptors.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC069541
Englishquetiapine, QUETIAPINE PREPARATION
Spanishquetiapina
Parent ConceptsSerotonin Antagonists (C0036753), Antipsychotic Agents (C0040615), Dibenzothiazepines (C0012033), [CN709] ANTIPSYCHOTICS, OTHER (C0973508), Dibenzoxazepine derivative antipsychotic agent (C0304389), Atypical antipsychotic (C1276996), Mood stabilizing drug (C1276998), Drug allergen (C1320237), Non-phenothiazines/ Atypicals (C1579416)
SourcesLNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Seroquel (C0287163)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC069541
EnglishAstraZeneca Brand of Quetiapine Fumarate, Seroquel, Zeneca Brand of Quetiapine Fumarate
SourcesMSH, MTH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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