Zyprexa (Olanzapine) Flashcards

Drug Classification

• Zyprexa is classified as an atypical antipsychotic.

Dose Range

• Oral (PO) dosage varies from 5-20 mg/day, tailored to specific diagnoses.
• Depot injection options include:
  • Intramuscular (IM) administration of 210 mg every 2 weeks.
  • IM administration of 405 mg every 4 weeks.

Pharmacological Action

• The drug acts by antagonizing both dopamine and serotonin receptors.

Therapeutic Uses

• Effective in treating schizophrenia.
• Utilized for acute manic or mixed episodes.
• Employed in maintenance therapy for bipolar I disorder.
• Addresses acute agitation and depressive episodes associated with Bipolar I mania.
• Option for treatment-resistant depression.

Side Effects/Adverse Effects

• Risk of neuroleptic malignant syndrome.
• Possible seizures and suicidal thoughts.
• Monitoring required for increased liver enzyme levels.
• Agranulocytosis may occur.
• Common issues include weight gain, constipation, extrapyramidal symptoms (EPS), and sexual dysfunction.

Medication/Food Interactions

• Concurrent use of Tegretol, omeprazole, or rifampin decreases Zyprexa's effectiveness.
• Zyprexa increases the effects of antihypertensive medications.
• Avoid using IM Zyprexa alongside parenteral benzodiazepines.

Nursing Interventions/Client Education

• Gradually discontinue the medication to prevent withdrawal.
• Educate patients about potential extrapyramidal symptoms and tardive dyskinesia.
• Instruct patients to notify their doctor of suicidal thoughts or any new/worsening mental health symptoms.
• Prior to dose adjustments, monitor EKG, heart rate, and pulse.
• Alert healthcare provider about signs such as anger, violence, fever, bleeding, bruising, rash, and post-injection delirium/sedation syndrome.
• Inform the healthcare provider if pregnant or breastfeeding.

Nursing Administration (Concerns)

• Conduct evaluations of complete blood count (CBC) and liver function during treatment.
• Ocular exams should be performed periodically.
• Monitor for possible decreases in platelets.
• Assess blood glucose levels due to potential metabolic effects.
• Be aware of risks for hyperlipidemia and monitor weight and body mass index (BMI).
• Monitor for neuroleptic malignant syndrome (NMS).

Evaluation of Medication Effectiveness

• Look for decreased excitable, manic behavior.
• Monitor for reductions in delusions and hallucinations related to schizophrenia.
• Evaluate improvements in social interactions and emotional responsiveness.
• Patient should report an increased sense of well-being and reduced agitation.