Leveraging Knowledge of Clozapine's Pharmacodynamics and Pharmacokinetics to Improve Outcomes-Presentation and Q&A

Video Transcription

Video Summary

In this video, Dr. Robert Cotes discusses the pharmacodynamics and pharmacokinetics of clozapine and its use in treating treatment-resistant schizophrenia. Clozapine is a medication used to treat serious mental illnesses and has a unique mechanism of action and receptor binding profile. It acts as an antagonist at multiple receptors, including serotonin 2A and dopamine D2, and is a partial agonist at serotonin 1A. The drug has a narrow therapeutic index, and its levels should be monitored regularly. Dr. Cotes explains common drug-drug interactions with clozapine, such as inhibitors and inducers of CYP enzymes, and how they can increase or decrease the drug's levels. He also discusses the side effects of clozapine, including sedation, tachycardia, orthostatic hypotension, constipation, hyperphagia, weight gain, and sialorrhea. The management of these side effects and the use of clozapine in pregnancy and lactation are also addressed. Clozapine-induced myocarditis is discussed as a potential risk, and Dr. Cotes explains that it is generally reversible with early detection. He also emphasizes the importance of weighing the risks and benefits of clozapine use and involving patients in shared decision-making. Overall, the video provides a comprehensive overview of clozapine's pharmacodynamics, pharmacokinetics, and use in psychiatric practice.

Keywords

clozapine

pharmacodynamics

pharmacokinetics

treatment-resistant schizophrenia

receptor binding profile

drug-drug interactions

side effects

sedation

weight gain

shared decision-making