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118 Cards in this Set
- Front
- Back
What is the only SSRI that is PC D? Why?
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paroxetine hydrochloride, pulmonary HTN, others are C
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What CYP for fluoxetine and paroxetine? What DI to watch out for?
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2D6, 1c antiarrhythmics
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What is only SSRI hepatically excreted?
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fluoxetine
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What brand name of fluoxetine if used for PMDD (premenstrual dysphoric disorder)?
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serefem
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What AE SSRI and warfarin?
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highly protein bound
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What SSRI causes weight gain?
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paroxetine (pudgy)
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What SSRI causes weight loss?
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fluoxetine (L for loss)
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What other AD makes you lose weight?
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bupropion
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What is SE of sertraline?
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diarrhea
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What SSRI does not come as a oral solution?
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fluvoxamine
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What is a CI for Zoloft solution?
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disulfram, because has alcohol in it
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What SSRI has ODT?
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citalopram
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What SSRI has once weekly dosing?
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fluoxetine, 90mg
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What is max dose for bupropion?
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SR is 400mg/day, 450mg/day for others
SR can't be given withing 8hrs of each other (BID dosing) |
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What is only SSRI for kids? What age?
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fluoxetine, 8 years or older
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What is fluoxetine metabolite?
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norfluoxetine
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Which has longer t1/2 fluoxetine or norfluoxetine?
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norfluoxetine
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What cyps for bupropion?
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2D6 inhibitor, 2B6 metabolizes
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What is sertraline metabolite?
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n-desmethylsertraline
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What are the secondary TCAs?
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amoxapine, desipramine (Norpramin), nortriptyline (Pamelor), protriptyline (Vivactil)
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What are the tertiary TCAs?
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amitriptyline, clomipramine (Anafranil), doxepin (Sinequan), imipramine (Tofranil), trimipramine (Surmontil)
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What is the SNRI that is indicated only for obesity?
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Meridia (Sibutramine)
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How long for antidepressant effect with AD drugs?
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see improvement at 2 weeks, 4-6 weeks for max effect
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What is TCA with least sedation? Why?
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desipramine (Norpramin), least H1 receptor affinity
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What is TCA with greatest NE effects?
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desipramine (Norpramin)
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What is the only topical TCA?
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doxepin (Sinequan)
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Which TCA is used for fibromyalgia?
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amitriptyline
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Which TCA is used for COPD?
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protriptyline (Vivactil)
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What TCA is better to use in elderly? Why?
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desipramine (Norpramin), less anticholinergic, in glaucoma don't have to worry about ocular pressure
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Which TCA has the highest chance of decreasing seizure?
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clomipramine (Anafranil)
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Which SNRI is a 2D6 inhibitor?
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duloxetine
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Which SNRI is used in fibromyalgia?
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duloxetine
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What is Nefazodone (Serzone) BBW?
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hepatic failure
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What is Trazodone BBW?
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suicide
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What trazodone AE and what causes them?
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dizziness form anti alpha 1
sedations from antihistmine priapism more in men |
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What is a nefazodone (Serzone) AE?
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more priapism effect in women
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What triazolopyridine has the longest t1/2?
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nefazodone (Serzone)
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How long is acute tx for depression?
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3 months
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How long is continuation tx for depression?
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4-9 months
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What is criteria for indefinite tx of depression?
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anyone with 3 episodes or more
anyone > 50 years old with 2 episodes anyone > 60 years old with 1 episode |
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Which AD have worst withdrawal?
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paroxetine and venlafaxine
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What is another drug that SSRIs interact with?
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triazoloBDZ
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What is the main AE for bupropion?
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seizures/tics
if on something for seizures and stable can give |
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What effect does trazodone have on digoxin?
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increase concentration
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What drugs are used for serotonin syndrome?
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cyproheptadine (Periactin), methysergide, propranolol, dantrolene (Dantrium) (for hyperthermia)
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What is required when taking methysergide for migraine?
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6 month drug holiday
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What is main use for trazodone?
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help them sleep
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What is only MAOI with a patch?
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selegiline (Eldepryl)
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What foods should be avoided in MAOI?
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chees and wine, high in tyramine
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What was the first MAOI used?
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Iproniazid
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How do you manage MAOI htn crisis?
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acidify urine with vit C and use IV BB
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What does MAO A metabolize?
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5-ht, epi, ne, mor in intestine
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What does MAO B metabolize?
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DA
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What effect does MAOI have on heart?
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suppress s/s of angina, watch for MI
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Which MAOIs are hydrazine derivatives?
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isocarboxazid (Marplan), phenelzine (Nardil)
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How long do you wait after taking fluoxetine before starting MAOI (vice versa)?
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5 weeks
2 week if go from MAOI to fluoxetine |
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Which MAOI regains normal MAO the fastest?
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tranylcypromine (Parnate)
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What is active ingredient in St. Johns wort?
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hypericum
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What can you take to make Adderall absorb more?
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antacid
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What methylphenidate dosage form is a patch?
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Daytrana
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What methylphenidate is 30% IR and 70% ER?
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Metadate CD
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What methylphenidate is the OROS dosage form, and how is it released?
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Concerta, first part is released in 1 hour, the rest lasts 5-9 hours
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What methylphenidate is available as a solution and chewable tablet?
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Methylin
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What methylphenidate is available as SODAS (spheroidal oral drug absorption) form and 50/50 ratio of IR/ER?
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Ritalin LA
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What is the max dose for methylphenidate?
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72mg for Concerta
60mg for the rest |
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Which isomer of methylphenidate is more active, D or L?
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D isomer
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What is metabolite of methylphenidate?
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ritalinic acid or PPA
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Which form of methylphenidate do you poop the tablet?
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Concerta
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How long do you wear the patch and where do you put it for Daytrana?
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Wear patch for 9hrs on hip, lasts for 12 hours, put on 2hrs before you want effect, alternate hip
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What methylphenidate should no be given if there is a GI obstruction?
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Concerta
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What are the main things you worry about with stimulants?
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glaucoma, tics, HTN, wt loss, insomnia, MAOIs
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What methylphenidate is wax matrix SR tablet?
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Ritalin SR
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What is one drug that should not be given with stimulants?
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clonidine
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What methylphenidate is hydrophilic polymer ER tab?
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Methylin ER
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Which stimulants are IR tablet?
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Ritalin, Methylin, Focalin (dexmethylphenidate), Dexedrine (dextroamphetamine), Adderall
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What methylphenidate is wax matrix ER tablet?
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Metadate ER
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What stimulant is SR beads?
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Dexedrine Spansules (dextroamphetamine)
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Which methylphenidate is eurand diffucaps technology?
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Metadate CD
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Which stimulant is microtrol IR and controlled release beads, 50/50 ratio IR/ER?
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Adderall XR
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Why isn't atomoxetine (Strattera) addictive?
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doesn't work in nucleus accumbens
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What is MOA of atomoxetine (Strattera)?
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selective NE reuptake inhibitor
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What is atomoxetine (Strattera) BBW?
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suicide
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How many symptoms do you have to have to be diagnosed with ADHD?
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6 for 6 months, have to diagnose before 7 months
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What are the 2 sections of ADHD?
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attention and hyperactivity
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Where does ADHD have to be diagnosed?
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2 different locations; home, school, physicians office
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What is MOA of triptans?
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5-HT1B and 5-HT1D receptor agonists
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Which triptan is not renally dosed because it is only 10% renally excreted?
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Frovatriptan (Frova)
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Which triptan has the longest t1/2?
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frovatriptan (Frova)
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Which triptans are ODT?
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zolmitriptan (Zomig) and rizatriptan (Maxalt)
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Which triptans have nasal spray?
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zolmitriptan (Zomig) and sumatriptan (Imitrex)
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What is the triptan with SQ injection?
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sumatriptan (Imitrex)
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What vitamin can be given for migraine prophylaxis?
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B2 (riboflavin) and Mg also
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What herbals can be given for migraine?
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feverfew and bilberry
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Which triptan is used for cluster HA?
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sumatriptan (Imitrex) injection
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When can you repeat triptans?
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naratriptan (Amerge) 4 hours, sumatriptan (Imitrex) 1 hour, all others are 2 hours
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Which triptan's t1/2 increases in the elderly?
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eletriptan (Relpax)
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What triptan is CI for severe renal impairment (CrCl <15)?
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naratriptan (Amerge)
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What triptans are CI for severe hepatic impairment?
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naratriptan (Amerge), sumatriptan (Imitrex), eletriptan (Relpax)
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What triptans are CI for cerebrovascular or peripheral vascular syndromes?
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naratriptan (Amerge) and sumatriptan (Imitrex)
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What triptans are CI for peripheral vascular disease?
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frovatriptan (Frova) and eletriptan (Relpax)
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Can you give SSRI with triptan?
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can, but watch out for serotonin syndrome
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What is fluoxetine/olanzapine?
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Symbyax, SSRI and atypical antipsychotic, for depression
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Which triptan is 3A4?
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eletriptan (Relpax)
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Which SSRIs are 3A4?
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fluoxetine and fluvoxamine
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Which SSRI is 1A2?
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fluvoxamine
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What is sumatriptan/naproxen?
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Treximet
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What is Midrin?
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isometheptene, APAP, dichloralphenazone
C4 control |
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What does isometheptene do?
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vasoconstrictor, works on alpha beta
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What SSRI have the highest sexual dysfunction?
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fluoxetine and paroxetine
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Which triptan causes somnolence?
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rizatriptan (Maxalt)
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What triptan is the most plasma protein bound?
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eletriptan (Relpax)
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What receptor does sumatriptan (Imitrex) bind?
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5-HT1
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What triptans bind to 5HT1b,d, and f?
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almotriptan (Axert) and eletriptan (Relpax)
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What triptans bind to 5HT1b and 5HT1d?
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frovatriptan (Frova), zolmitriptan (Zomig), and rizatriptan (Maxalt)
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What triptan binds to 5-HT1d only?
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naratriptan (Amerge)
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Does frovatriptan (Frova) bind to BDZ receptor sites?
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no
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Which SSRI is excreted the most in breast milk?
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fluoxetine
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Which SSRI is excreted the least in breast milk?
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sertraline
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