Related Experiment Video
Updated: May 26, 2025
05:51
Induction and Assessment of Levodopa-induced Dyskinesias in a Rat Model of Parkinson's Disease
Published on: October 14, 2021
3.6K
Olanzapine; Postinjection Syndrome; Pharmacokinetics in View
Johanne Rozema1, Cornelis Paul van Stee2, Daniel J Touw1
1Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, the Netherlands.
Therapeutic Drug Monitoring
|February 25, 2025
Summary
This case study details a patient experiencing severe Postinjection Delirium/Sedation Syndrome (PDSS) after olanzapine depot injection. Therapeutic drug monitoring revealed a prolonged olanzapine half-life, aiding in recovery and guiding future treatment decisions.
Area of Science:
- Pharmacology
- Clinical Toxicology
- Psychiatry
Background:
- Olanzapine is a second-generation antipsychotic used for schizophrenia maintenance.
- Slow-release intramuscular depot formulations are common.
- Postinjection Delirium/Sedation Syndrome (PDSS) is a rare but serious adverse effect.
Purpose of the Study:
- To present a case study of PDSS following olanzapine depot injection.
- To detail the pharmacokinetics of olanzapine in a patient with PDSS.
- To highlight the role of therapeutic drug monitoring in managing PDSS.
Main Methods:
- Case report of a 64-year-old male patient presenting with PDSS symptoms.
- Serial serum olanzapine level measurements (Days 0, 1, 3, 12).
- Pharmacokinetic analysis, including calculation of olanzapine half-life.
Main Results:
- Patient presented with hypertension, tachycardia, and delirium, with serum olanzapine levels reaching 390 mcg/L.
- Calculated prolonged olanzapine half-life of 7 days.
- Symptoms resolved within 72 hours; full recovery achieved.
Conclusions:
- This case underscores the importance of recognizing and managing PDSS.
- Therapeutic drug monitoring is crucial for understanding olanzapine pharmacokinetics in PDSS.
- Monitoring aids in determining safe resumption of medication.
Related Concept Videos
01:26Psychosis: Goals of Pharmacotherapy
102
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
102
01:20Antiepileptic Drugs: Potassium Channel Activators
140
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
140
00:59Nonlinear Pharmacokinetics: Drug Elimination for IV Bolus Injection
36
In pharmacokinetics, the elimination rate of a drug following a capacity-limited model is primarily controlled by two parameters: Vmax and KM. These parameters are crucial in how the drug behaves inside the body after administration.
Following the administration of a single intravenous (IV) bolus injection, we can determine the concentration of the drug in the plasma at any given time. This calculation is achieved using a specific equation that integrates the values of Vmax and KM.
We can also...
Following the administration of a single intravenous (IV) bolus injection, we can determine the concentration of the drug in the plasma at any given time. This calculation is achieved using a specific equation that integrates the values of Vmax and KM.
We can also...
36
01:19One-Compartment Open Model for IV Bolus Administration: General Considerations
148
The one-compartment model is a pharmacokinetic tool that models the body as a single, uniform compartment, facilitating the understanding of drug distribution and elimination. This model is particularly beneficial for intravenous (IV) bolus administration, where the drug rapidly circulates throughout the body.
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...
148
01:21Antipsychotic Drugs: Typical and Atypical Agents
146
Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
146
01:29Drug Delivery: Parenteral Route
372
The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
372