Antipsychotics

Question 1

By what routes can olanzapine be administered?

Answer 1

Oral (tablet or wafer), IM

Question 2

A patient arrives to the ED with a stab wound to his leg. He is agitated. What dose and route of administration of olanzapine would you use?

Answer 2

10-20mg IM, unless he will accept oral, in which case it is the same dose.

Question 3

What are the advantages of olanzapine over the older “typical” antipsychotics?

Answer 3

Olanzapine has more 5HT2A blockade and less D2 blockade, therefore has less extrapyramidal side effects. Less hypotension, less tachycardia, multiple routes of administration.

Question 4

What are the disadvantages of olanzapine?

Answer 4

Anticholinergic effects

Lowered seizure threshold

Weight gain

Diabetes

Hyperlipidaemia

(2 to pass)

Question 5

What are the pharmacodynamics of haloperidol?

Answer 5

D2 antagonism (dopamine antagonism), with high rate of extra-pyramidal side effects.