Zyprexa

You might see Zyprexa (olanzapine) used to prevent nausea and vomiting in cancer patients.
     It's sometimes helpful. It probably works like other antiemetics...by blocking dopamine and serotonin receptors.
     Zyprexa is a dopamine antagonist...similar to prochlorperazine, metoclopramide, and droperidol.
     Zyprexa also blocks serotonin 5HT3 receptors...similar to Zofran, Kytril, Anzemet, and Aloxi.
     Consider Zyprexa if you need to prescribe something...and nothing else is working.
     Caution patients that Zyprexa can be sedating, especially when combined with opioids or other sedating drugs.

Prescriber's Letter: June 2004; Vol: 11, No. 6

Monitoring zyprexa: associated with weight gain and diabetes. Patients on atypicals: risperdal, zyprexa, seroquel, etc, are at risk for obesity, diabetes, dyslipidemia. Check weight at baseline, then 1,2,3 mos after starting or changing therapy, and then q3mos.  Fasting glucose and BP at baseline, 3 mos, and then annually. Lipids at baseline, 3 mos, then q5 years if normal.