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Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Loxapine Pharmacology

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5716 Ratings

🗓️ 17 July 2025

⏱️ 15 minutes

🧾️ Download transcript

Summary

Loxapine is a first-generation (typical) antipsychotic with dopamine D2 receptor antagonism as its primary mechanism, though it also has affinity for serotonin 5-HT2A receptors, making its pharmacology somewhat atypical.



Loxapine is available in multiple formulations, including oral capsules and an inhalation powder, the latter approved specifically for acute agitation in patients with schizophrenia or bipolar I disorder.



Sedation and extrapyramidal symptoms (EPS), including dystonia, akathisia, and parkinsonism, are common adverse effects due to its potent dopamine blockade in the nigrostriatal pathway.



Orthostatic hypotension can occur with loxapine due to its alpha-1 adrenergic blockade, requiring monitoring in elderly patients or those on antihypertensives.

Transcript

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0:00.0

Hey, all, welcome back to the Real Life Pharmacology podcast. I'm your host, pharmacist, Sarah Christensen.

0:05.3

Thank you so much for listening today. Head on over to real life pharmacology.com. Get your free 31 page

0:11.0

PDF on the top 200 drugs. Great little study guide, great refresher if you're out in practice or preparing for

0:16.8

pharmacology exams. So go take advantage of that. Simply an email.

0:21.9

We'll get you access to that.

0:25.8

Also get you updates when we got new podcasts and content available as well.

0:30.5

While you're there at Real Life Pharmacology, go look at the podcast tab.

0:32.7

We've done over 300 episodes.

0:34.5

I think we're getting close to 400 now.

0:40.4

Go take advantage of those previous episodes. Really, stuff doesn't change too much as far as adverse effects and mechanism and all that sort of thing. So yeah, go take advantage

0:45.4

of some of those old podcasts. If you're studying a specific topic, you can see on the right hand

0:50.0

side there, we've got them categorized as well. So cardiovascular, for instance, and so on and so

0:55.8

forth. So again, go take advantage of that at real-life pharmacology.com. All right, let's get into the

1:02.6

drug of the day today, and that is loxapine. Brand name of this medication is Loxetane. That is an old,

1:09.6

old brand name. There's also an

1:12.8

inhalation form called Adisouvet, I believe is how it's pronounced. I have not seen this

1:19.9

inhaled formulation utilized, but I'll give you a brief rundown on that a little bit as well.

1:25.9

So indications, this medication is used for

1:31.2

schizophrenia, bipolar disorder, and agitation associated with those disease states. As you could imagine,

1:39.2

this is an antipsychotic. It blocks dopamine or two receptors as well as some other things.

1:47.0

But this is a first generation antipsychotic, which it probably explains why you don't see it as often.

1:55.4

Mechanistically, I alluded to the dopamine blocking action. Certainly this medication has that.

...

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