Hyperventilation and Respiratory Alkalosis After Olanzapine for Insomnia: A Case Report.
Journal
A&A practice
ISSN: 2575-3126
Titre abrégé: A A Pract
Pays: United States
ID NLM: 101714112
Informations de publication
Date de publication:
20 Oct 2021
20 Oct 2021
Historique:
entrez:
21
10
2021
pubmed:
22
10
2021
medline:
26
10
2021
Statut:
epublish
Résumé
Olanzapine is increasingly used as a sleep aid in hospitalized patients. Although thought to have less extrapyramidal effects, known side effects include oversedation, arrythmias, and hypotension. We present the unusual case of hyperventilation with respiratory alkalosis after the administration of olanzapine for insomnia in an elderly postoperative patient. This led to a second admission to the intensive care unit with invasive interventions including mechanical ventilation and vasopressor support. Caution must be exercised in prescribing antipsychotics for off-label use, especially in a population whose baseline characteristics can affect the pharmacokinetics of second-generation antipsychotics.
Identifiants
pubmed: 34673660
doi: 10.1213/XAA.0000000000001535
pii: 02054229-202110000-00007
doi:
Substances chimiques
Antipsychotic Agents
0
Olanzapine
N7U69T4SZR
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e01535Informations de copyright
Copyright © 2021 International Anesthesia Research Society.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Morin AK. Off-label use of atypical antipsychotic agents for treatment of insomnia. Mental Health Clinician. 2014;4:65–72.
Alexander GC, Gallagher SA, Mascola A, Moloney RM, Stafford RS. Increasing off-label use of antipsychotic medications in the United States, 1995-2008. Pharmacoepidemiol Drug Saf. 2011;20:177–184.
Maguire GA. Impact of antipsychotics on geriatric patients: efficacy, dosing, and compliance. Prim Care Companion J Clin Psychiatry. 2000;2:165–172.
Mouallem M, Wolf I. Olanzapine-induced respiratory failure. Am J Geriatr Psychiatry. 2001;9:304–305.
Isbister GK. Droperidol or olanzapine, intramuscularly or intravenously, monotherapy or combination therapy for sedating acute behavioral disturbance. Ann Emerg Med. 2017;69:337–339.
Jana AK, Praharaj SK, Roy N. Olanzapine-induced orthostatic hypotension. Clin Psychopharmacol Neurosci. 2015;13:113–114.
Markowitz JS, DeVane CL, Boulton DW, Liston HL, Risch SC. Hypotension and bradycardia in a healthy volunteer following a single 5 mg dose of olanzapine. J Clin Pharmacol. 2002;42:104–106.
Sattar SP, Gastfriend DR. Olanzapine-induced hyperventilation: case report. J Psychiatry Neurosci. 2002;27:360–363.
Olson EB Jr, Dempsey JA, McCrimmon DR. Serotonin and the control of ventilation in awake rats. J Clin Invest. 1979;64:689–693.
Shelton PS, Barnett FL, Krick SE. Hyperventilation associated with quetiapine. Ann Pharmacother. 2000;34:335–337.
Hilaire G, Voituron N, Menuet C, Ichiyama RM, Subramanian HH, Dutschmann M. The role of serotonin in respiratory function and dysfunction. Respir Physiol Neurobiol. 2010;174:76–88.
Hodges MR, Richerson GB. The role of medullary serotonin (5-HT) neurons in respiratory control: contributions to eupneic ventilation, CO 2 chemoreception, and thermoregulation. J Appl Physiol (1985). 2010;108:1425–1432.
Hirose S. Restlessness of respiration as a manifestation of akathisia: five case reports of respiratory akathisia. J Clin Psychiatry. 2000;61:737–741.
Fayek M, Kingsbury SJ, Zada J, Simpson GM. Cardiac effects of antipsychotic medications. Psychiatr Serv. 2001;52:607–609.