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Important nteractions one should check out for: Corticosteroids — additive hyperglycemic Thiazide diuretics — additive glucose elevation Non-selective beta-blockers (e.g., propranolol) — can mask hypoglycemia symptoms in insulin/sulfonylurea users CYP1A2 modulators (e.g., smoking cessation during admission) — can raise olanzapine levels unexpectedly QT-prolonging co-prescriptions (fluoroquinolones, macrolides, ondansetron) — additive QTc risk Anticholinergic burden — can worsen diabetic gastroparesis 3.Interventions Baseline and periodic fasting glucose, lipid panel, weight/BMI Track HbA1c trend from olanzapine initiation Discuss risk-benefit of lower metabolic-risk alternatives (e.g., aripiprazole) where clinically appropriate Don't dismiss deteriorating glucose control as "just illness stress" — screen actively This is the kind of case that reminds us why the pharmacist's seat at the ward round table matters — catching interactions that aren't always obvious on a first glimpse of a prescription