Lurasidone Pharmacology

On this podcast episode, I discuss lurasidone pharmacology, adverse effects, and drug interactions.

CYP3A4 is an important enzyme in the breakdown of lurasidone. I discuss this further on this episode.

Lurasidone is best taken with food as this enhances absorption and helps improve drug concentrations.

Lurasidone tends to have a lower risk for metabolic syndrome compared to other antipsychotics which is a nice advantage.

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Olanzapine Pharmacology

Olanzapine is a 2nd generation antipsychotic that blocks dopamine-2 receptors.

Olanzapine Relprevv (long acting injectable) needs to be closely monitored after the injection is given due to risks of sedation and delirium.

Sedation is a common occurance with the use of olanzapine. It is one of the more sedating second generation antipsychotics.

Weight gain, hyperlipidemia, and hyperglycemia are all potential adverse effects with olanzapine.

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I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

Benztropine Pharmacology

Benztropine Pharmacology

Benztropine is a highly anticholinergic medication that is primarily used for movement disorders.

Antipsychotics can cause extrapyramidal adverse effects that can help be managed with benztropine.

Because benztropine is highly anticholinergic, it can cause dry eyes, dry mouth, urinary retention, constipation and contribute to falls and confusion, particularly in our elderly population.

While benztropine is classified as an anti-Parkinson’s agent, it is rarely used for that indication as it has a high incidence of anticholinergic adverse effects (particularly at the doses that are required for benefit).

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Clozapine Pharmacology

Clozapine Pharmacology

On this episode, I discuss clozapine pharmacology. This drug has multiple mechanisms of action: Dopamine blockade, anticholinergic activity, and alpha blocking activity all contribute to the complexity of this drug.

Smoking cessation can significantly increase the concentrations of clozapine. This is because smoking can induce CYP1A2. Listen to the podcast for more details on how this can impact our patients clinically.

Clozapine has 5 boxed warnings. I discuss them all in this podcast. The most well-known boxed warning is for agranulocytosis.

Because clozapine has alpha blocking activity, it can cause orthostasis. We need to monitor for this.

Clozapine can cause QTc prolongation. Keep an eye out for other medications that the patient may be taking that can also cause this. Examples include: amiodarone, ondansetron, quinolones, and macrolides

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