A patient who has diabetes mellitus is diagnosed with schizophrenia and the provider orders thioridazine. The patient asks the nurse why the provider hasn't ordered olanzapine [Zyprexa], which the patient has seen advertised on television
Which response by the nurse is the most im-portant reason that this patient is not receiving olanzapine? a. "Olanzapine is more expensive than thi-oridazine."
b. "Olanzapine causes more metabolic side effects than thioridazine."
c. "Thioridazine has fewer side effects than olanzapine."
d. "Thioridazine has a faster onset of action than olanzapine."
B
Olanzapine is an SGA and, although it has fewer extrapyramidal side effects than the FGA the provider has ordered, it has an increased risk of metabolic side effects, which is contraindicated in patients with diabetes. It is more expensive, but this is not the most important reason for not prescribing it. Thioridazine has more side effects than olanzapine, but the side effects caused by olanzapine are more critical for this patient. Thioridazine does not have a faster onset of action.
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