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Thrp: Exam 6 (Sleep,Thrombosis,Neurology) Flashcards

1
Q

Alcohol

A

Improves Sleep Latency
Tolerance: w/in 6 nights

AE: inc # of awakenings and length, residual daytime sedation, abuse/ dependence *Respiratory depression
Lots of DDI

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2
Q

Diphenhydramine

A

OTC Anti-Histamine for sleep: Ant H1/ACh Receptor
t1/2=5-11hrs
Dose: 25-50mg
Tolerance=3-7 days
Tx: mild/short-term insomnia
*NOT Elderly, NOT chronically, Peds? paradoxical rxn

(Benadryl)

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3
Q

Doxylamine

A

OTC Anti-Histamine for sleep: Ant H1/ACh Receptor
t1/2=6-12hrs
Dose: 25-50mg
Tolerance=3-7 days
Tx: mild/short-term insomnia
*NOT Elderly, NOT chronically, Peds? paradoxical rxn

(Unisom)

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4
Q

Valerian

A

OTC Herbal Supp for Sleep: maybe inc GABA
Dose: 300-600mg ??->(dried root 2-3g soaked hot water)
Efficacy: dec sleep latency by less than 1min
AE: Hepatotoxicity

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5
Q

Melatonin

A 
OTC Sleep: Mimic hormone, reg circadian rhytm
Dose:0.5-5mg
AE: HA, N/V/D, dizziness/hypotension,
*cases of seizure (rare but epileptics)
Poor data
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6
Q

Ramelteon

A

Insomnia (indicated): Melatonin (MT1/MT2-selective) Receptor AGonist
t1/2=1.5-5 hrs; MET hepatic
Dose: 8mg w/in 30min of HS
(studied strengths up to 32mg: found no inc efficacy and more SE)

AE: dizziness, abnormal thinking, CNS/Resp. depression, dec libido, sleep-related activities

(Rozerem - no generic) $$$
Efficacy: Dec sleep onset latency 10-15min; total sleep time inc 10-15min
No BDZ/”z-drug” comparative trials

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7
Q

Trazodone

A

Tx: sleep (if co-morbid condition): 5-HT RUI, H1/α1 Antagonist
t1/2= 6-10hrs; MET: hepatic
Dose: 25-100mg (depression ~600mg/day)
**use in pts with SSRI/bupropion-induced insomnia and ***BEST for elderly

AE: Edema, orthostasis (elderly) priapism, seretonin syndrome

Efficacy: often used 1st line, but only 1 RCT with poor results;
1st line?? dec AE/abuse potential and no tolerance

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8
Q

Doxepin

A

TCA (only TCA indicated for insomnia): 5-HT/NE RUI, H1 ANTagonist
(theory lower doses->mostly antihistamine action)
t1/2=15-30* hrs
Dose: 3-6mg PO 30min before bedtime

AE: Cardiac Prolongation (QT) (not safe in OD), Anti-ACh, orthostasis

Efficacy: for insomnia with sleep maintenance difficulty; NOT sleep onset (t1/2): Short term use
AVOID in elderly

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9
Q

Amitriptline

A

TCA (insomnia off label): 5-HT/NE RUI, H1 ANTagonist
(theory lower doses->mostly antihistamine action)
t1/2=15-30 hrs
Dose: 10-50mg

AE: Cardiac Prolongation (QT) (not safe in OD), Anti-ACh, orthostasis

Efficacy: for insomnia with sleep maintenance difficulty; NOT sleep onset (t1/2): Short term use
AVOID in elderly

**TCA: Level B Migraine Prevention Tx:
10-200mg PO HS

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10
Q

Mirtazapine

A

TCA; α2 Antagonist (so inc NE/5-HT) and 5-HT2/3, H1 Antagonist
t1/2= ~20-40hrsl MET- hepatic
Dose: 15-45mg (*Inverse rel between dose and sedation; use low dose for sedation)

AE: Wt Gain, daytime sedation, sleep related events, suicidal

(Remeron): Efficacy unclear, use only if underlying depression

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11
Q

Triazolam

A

BDZ (sleep): GABA Ag
t1/2= 2-5hr (short)
Dose: 0.125-.25mg

Improves sleep latency by 10min; Inc total seep time by 60 min (depends on t1/2) w/ inc NREM II and dec REM/NREM III-IV

CI: Pregnancy X, sleep apnea, Substance Abuse

AE (all worse with long acting, *EtOH): *dose dependent-daytime sedation, **Anterograde amnesia, impaired mem, rebound insomnia for 1-2 nights after d/c, psychomotor incoordination, dec concentration, cognitive deficits
*Tolerance for hypnotic efficacy in 2-4wks

**AVOID IN ELDERLY

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12
Q

Estazolam

A

BDZ (sleep): GABA Ag
t1/2= 10-24hr (intermediate)
Dose: 1-2mg

Improves sleep latency by 10min; Inc total seep time by 60 min (depends on t1/2) w/ inc NREM II and dec REM/NREM III-IV

AE (all worse with long acting, *EtOH): *dose dependent-daytime sedation, **Anterograde amnesia, impaired mem, rebound insomnia for 1-2 nights after d/c, psychomotor incoordination, dec concentration, cognitive deficits
*Tolerance for hypnotic efficacy in 2-4wks

**AVOID IN ELDERLY

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13
Q

Temazepam

A

BDZ (sleep): GABA Ag
t1/2=10-40hr (intermediate)
Dose: 15-30mg

Improves sleep latency by 10min; Inc total seep time by 60 min (depends on t1/2) w/ inc NREM II and dec REM/NREM III-IV

AE (all worse with long acting, *EtOH): *dose dependent-daytime sedation, **Anterograde amnesia, impaired mem, rebound insomnia for 1-2 nights after d/c, psychomotor incoordination, dec concentration, cognitive deficits
*Tolerance for hypnotic efficacy in 2-4wks

**AVOID IN ELDERLY

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14
Q

Flurazepam

A

BDZ (sleep): GABA Ag
t1/2=40-100 hr
Dose:15-30mg (Metabolite)

Improves sleep latency by 10min; Inc total seep time by 60 min (depends on t1/2) w/ inc NREM II and dec REM/NREM III-IV

AE (all worse with long acting, *EtOH): *dose dependent-daytime sedation, **Anterograde amnesia, impaired mem, rebound insomnia for 1-2 nights after d/c, psychomotor incoordination, dec concentration, cognitive deficits
*Tolerance for hypnotic efficacy in 2-4wks

**AVOID IN ELDERLY

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15
Q

Quazepam

A

BDZ (sleep): GABA Ag
t1/2=28-100hr
Dose: 7.5-15mg (metabolite)

Improves sleep latency by 10min; Inc total seep time by 60 min (depends on t1/2) w/ inc NREM II and dec REM/NREM III-IV

AE (all worse with long acting, *EtOH): *dose dependent-daytime sedation, **Anterograde amnesia, impaired mem, rebound insomnia for 1-2 nights after d/c, psychomotor incoordination, dec concentration, cognitive deficits
*Tolerance for hypnotic efficacy in 2-4wks

**AVOID IN ELDERLY

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16
Q

Alprazolam

A

BDZ: GAGA Ag *Not indicated/avoid in insomnia Tx
t1/2=12-15

Have active Metabolites; More rapid absorbed and Higher abuse potential

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17
Q

Clonazepam

A

BDZ: GAGA Ag *Not indicated/avoid in insomnia Tx
t1/2= 18-50

Have active Metabolites; More rapid absorbed and Higher abuse potential

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18
Q

Lorazepam

A

BDZ: GAGA Ag *Not indicated/avoid in insomnia Tx
t1/2=10-14

Have active Metabolites; More rapid absorbed and Higher abuse potential

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19
Q

Diazepam

A

BDZ: GAGA Ag *Not indicated/avoid in insomnia Tx
t1/2= 50-100

Have active Metabolites; More rapid absorbed and Higher abuse potential

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20
Q

Zaleplon

A

“Z-Drug”: GABAA AGonsist->↑sedation (use 3-6mo)
t1/2= 1hr
Dose 5-10mg
NOT good for maintenance (no better than BDZ)

AE: less (but same) than BDZ; Dose dependent
Rebound insomnia 1-2nights after d/c,

(Sonata)

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21
Q

Zolpidem

A

“Z-Drug”: GABAA AGonsist->↑sedation (use 3-6mo)
t1/2= 1.5-4
Dose: 5-10mg

(Ambien)

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22
Q

Zolpidem CR

A

“Z-Drug”: GABAA AGonsist->↑sedation (use ≥6mo)
t1/2= 6.25-12.5mg
Helps with maintenance

AE: less (but same) than BDZ; Dose dependent
Rebound insomnia 1-2nights after d/c,

(Ambien CR)

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23
Q

Zolpidem SL

A

“Z-Drug”: GAGAA AGonsist->↑sedation
t1/2=1.5-6hr
Dose:1.75-3.5mg
FOR Middle of the night in >4hrs left

AE: less (but same) than BDZ; Dose dependent
Rebound insomnia 1-2nights after d/c,

(Intermezzo)

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24
Q

Zolpidem Spray

A

“Z-Drug”: GAGAA AGonsist->↑sedation
t1/2=2-8hr
Dose 5mg

AE: less (but same) than BDZ; Dose dependent
Rebound insomnia 1-2nights after d/c,

(Zolpimist)

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25
Eszopiclone
"Z-Drug": GABAA AGonsist->↑sedation (use ≥6mo) t1/2=5-7hr Dose: 1-3mg Better for sleep maintenance AE: less (but same) than BDZ; Dose dependent Rebound insomnia 1-2nights after d/c, (Lunesta)
26
Insomnia Efficacy: BDZ
Sleep latency dec 10min | Sleep time: inc 33min
27
Insomnia Efficacy: "Z-Drugs"
Sleep Latency: dec 12.8min Sleep time: inc 12 min Elderly: Sleep time: inc 25min nighttime awakenings less than 1/night 5X as likely to have daytime sedation
28
Insomnia Efficacy: Antidepressants
Sleep latency: dec 7min | Sleep time: inc 80min
29
Modafinil
TX: (FDA-Labeled indications) - Narcolepsy-improve wakefulness for excessive daytime sleepiness - Obstructive Sleep Anpnea - improve sleepiness and adjunct with PAP - Shift work sleep disorder Dose:200-400mg QAM CIV, cautions inc BP, arrhythmias, CVD SE: Insomnia
30
Armodafinil
Tx: narcolepsy-excessive daytime sleepiness Dose: 150-250mg QAM SE: Insomnia
31
Dextroamphetamine
Stimulent approved to Tx: narcolepsy-excessive daytime sleepiness
32
methylphenidate
Stimulent approved to Tx: narcolepsy-excessive daytime sleepiness
33
Venlafaxine
SNRI approved to Tx Narcolepsy - Cataplexy, paralysis, hypnagogic hallucinations
34
fluoxetine
SSRI approved to Tx Narcolepsy - Cataplexy, paralysis, hypnagogic hallucinations
35
Sodium Oxybate
Only FDA approved Rx to Tx Narcolepsy - Cataplexy and excessive daytime sleepiness RESTRICTED DISTRIBUTION C-III (Xyrem)
36
Fondaparinux
``` Synthetic Pentasaccharide (Xa only via AT) (SC) Peak effect: 2-3hrs; **t1/2=15-18hrs *Renal Elimination ``` Dosing: VTE PROPHYLAXIS TKA,THA,HFS: 2.5mg SC Qday (-2nd line Orthopedic Surgical VTE Prophylaxis) Medically ill: Not recommended (not FDA approved) Dosing: VTE TREATMENT (Stratified dosing) 100kg = 10mg SC q24hr 50-100kg=7.5mg SC q25hr <30ml/min *(Arixtra) 2.5, 5, 7.5, 10mg pre-filled syringes
37
UFH
SC/IV: Peak effect 1-2hr t1/2 30-150min (dose dependent) *DOSING VTE Prophylaxis-TKA/THA/HFS/Trauma: NONE VTE Prophylaxis-medically ill/general surgery: 5000 U SC q8-12hr VTE Tx: 80U/kg IV bolus (round to 500U) Th 18U/kg/hr cont IV infusion (round to 100U) MONITORING aPTT (Baseline, 6hr after bolus, 6hrs after any infusion changes, once stable q24h) Goal = 1.5-2.5X normal aPTT value(test dependent) + CBC w/ platelets AE: Bleeding, osteoporosis, Hypersensitivity, Thrombocytopenia (HAT, HIT, HITT)
38
Protamine
UFH Reversal agent
39
Argatroban
Direct Thrombin Inhibitor (IV) **Hepatic Elimination DOSING: 2µg/kg/min Hepatic dysfn = 0.5-1.2µg/kg/min ``` MONITORING aPTT (Baseline, 6hr after bolus, 6hrs after any infusion changes, once stable q24h) Goal = 1.5-2.5X normal aPTT value(test dependent) ``` AE: Bleeding
40
Lepirudin
Direct Thrombin Inhibitor (IV) Renal Elimination Monitor aPTT AE: Bleeding * Antibody development: IF been Tx once do not use again
41
Bivalirudin
Direct thrombin inhibitor: (IV) Renal/Enzymatic elimination **FDA Approved Indication = Hx of H.I.T. and undergoing angioplasty or PCI MONITOR: aPTT AE: bleeding
42
Vitamin K
Warfarin Antidote Tx: On warfarin @time of HIT Dx PO: 10mg IV: 5-10mg
43
Desirudin
Direct Thrombin Inhibitor (SC) FDA-indication=DVT Prophylaxis w/hip replacement *NOT for H.I.T Tx
44
Enoxaparin
LMWH (SC) Peak effect 3-5hr; t1/2=3-6hr *RENAL Elimination *Dosing: VTE PROPHYLAXIS TKA,THA,HFS: 30mg SC q12h (Preferred Orthopedic Surgical VTE Prophylaxis) Trauma: 30mg SC q12h Medically ill/General Surgery: 40mg SC q24hr *Renal impairment (CrCl<30ml/min): 1mg/kg SC q24hrs, use with caution consider another Tx *(Lovenox) 30, 40, 60, 80, 100, 120, 150MG pre-filled syringes
45
Dalteparin
LMWH (SC) Peak effect 3-5hr; t1/2=3-6hr *RENAL Elimination Dosing PROPHYLAXIS TKA,THA,HFS: 5000 Units SC q24hr Trauma: NONE Medically ill/General Surgery: 5000 Units SC q24hrs *Renal impairment (CrCl<30ml/min): Use with caution consider alternative tx. *(Fragmin) 2500, 5000, 7500, 10000, 12500, 15000, 18000 UNIT pre-filled syringes
46
Phenytoin
AED: Broad Spec: Most Common MOA: Inhibits Voltage gated Na+ Channels DOSE: Loading dose regime PO: 200mg Acid form = 92mg Sodium form** Parenteral: IV (Max 50mg/min); Fosphenytoin (Max 150mg/min*) PK: ~92% protein bound; **Non-linear kinetics- lg pt variability in levels; t1/2=22hrs (why loading) *should not repeat levels for 5-7 days after dosage change AE: Dose deepen: Dizziness, lethargy, seizures, visual changes (sign to have levels checked) Idiosyncratic=SJS Chronic: Gingival hyperplasia (reversible)
47
Carbamazepine
AED: Broad spec MOA: Bind voltage-dependant Na+ channels Dosing: *Titrate up many dosage forms- (XR form = BID w/ghosts) PK: - induces its own metabolism (2C9&3A4 substrate and inducer) - >**21-28 days to reach steady state (not due to t1/2) - 40-90% Protein bound AE Dose depen: Diplopia, dizziness, unsteadiness Chronic: **Hyponatremia-sx=nausea,malaise,HA,obtundation (*careful to not correct Na+ too quickly => locked in syndrome), dec BMD (supp Ca++/VitD/Folic Acid) Monitor-base line and periodic CBC w/ platelets, LFT sNa+, renal fn
48
Oxcarbazepine
AED: Adj or mono-Tx for partial seizures (similar efficacy CBZ,PHT,VPA but better tolerated) MOA: blocks voltage-dependant Na+ channels Dosing: Titrate up Gradually (w/o regard to meals) AE: - idiosyncratic: Rash (not SJS but stop Rx) cross-reactivity w/ CBZ - Chronic: **Hyponatremia more than CBZ-sx=nausea,malaise,HA,obtundation (*careful to not correct Na+ too quickly => locked in syndrome) Monitor: sNa+ DDI: deceases OC** ; overall fewer DDI then CBZ, may induce UGT
49
Valproate/Divalproex Sodium
AED: Broad Spec Rx - 1st line generalized seizures MOA: Multiple Dosing: Titrate up - Take WITH FOOD (XR/IV available) PK: Highly Protein bound, well absorbed, *diurnal elimination (serum levels lower in pm - monitoring) AE: - Dose Depen: *GI upset (w/food) - idiosyncratic: acute hepatic failure - Chronic: *Wt gain DDI LOTS: inhibitor, Will dec phenobarb lebels **VPA+OC dec VPA levels due to inc met
50
Lamotrigine
AED: OK w/ pregnancy; Tx:Broad Spec, well tolerated MOA: blocks voltage-dependant Na+ channels Dosing: *Dose depends on concomitant AED's; Titrate UP (if with VPA start LOW dose 25mg QOD) AE: Idiosyncratic- *SJS* DDI: OC-dec [OC] and dec [lamotrigine] on off weeks
51
Levetiracetam
AED: *Best tolerated few DDI: Indicated Adjectively partial; but used 1st line broad MOA: bocks Ca++ channel, effects glutamate vesicle Dosing: Titrate up; high doses tolerated well w/ or w/o food AE: -idiosyncratic: Psychosis (profound)=DLT Renally eliminated: dose adj
52
Lacosamide
AED: a schedule V AED MOA: unknown Dosing: Titrate up IV form available AE: [ ] depen: Profound vomiting
53
Phenobarbital
AED: Broad; IV-very common, PO not used* MOA: GABAa Dosing: Titrate gradually (30mg q2-4wks) Monitoring: CBC w/platelets, LFT PK: t1/2=1-5days (total clear of drug 5 days: brain dead Pts) AE: A lot** why dec use idiosyncratic: *SJS chronic: intellectual blunting, bone disease (ca++/vitD) DLT=sedation
54
Topiramate
AED: Broad Spec MOA: block AMPA/kainate,Na++/Ca++ channels; enhance GABA Dosing: Titrate up (slow) w/ or w/o food Migraine Prophy: 50mg BID (titrate up 25mg/wk) AE: - [ ] depen: concentration diff., speech/language problems, - idiosyncratic: metabolic acidosis(monitor) - chronic: kidney stones, **Wt. loss DDI: Signifigantly dec OC efficacy at Top.doses >200mg/day (not a problem for migraine prophylaxis)
55
Tiagabine
AED: NEVER mono therapy or 1st line, NOT used
56
Zonisamide
AED: adj partial seizures **Teratogenic; fairly well tolerated MOA: Block Na++/Ca++ chan and CA Dosing: slow titrate up w/o regard to meals AE: Chronic: kidney stones (hydrate) has sulfonamide chain and carbonation taste perversion
57
Gabapentin
AED: Not used in seizure much; larger Tx w/neuropathic pain MOA: enhances GABA Dosing:Titrate up w/o regard to meals No monitoring required, but renally eliminated
58
Pregabalin
AED: Not used in seizure much(limited experience); larger Tx w/neuropathic pain Schedule V Dosing: Rapid titration
59
Felbamate
AED: Only a LAST line Tx; lots of SE including Aplastic anemia, liver failure (MedWatch)
60
Rufinamide
AED: Tx: adj for Lennox-Gastaut (childhood form)
61
Ethosuxamide
AED: 1st line absence seizures ONLY (verry narrow spec) | well tolerated
62
Ezogabine
NEW AED: adj partial onset | AE: urinary retention
63
Perampanel
NEW AED: adj partial onset (not approved Yet) | AE: Aggressive behavior
64
Methylprednisolone
MS Tx of relapses 1000mg IV Qday X3days (po=IV efficacy) SE: Exacerbation of infection in pts at inc risk with DMT Rxs
65
Avonex
RRMS Tx: Interferon Beta-1a Injection (Most common with rebif) (Pre-filled syringes: stable 7days at RT diluent form: stable 30days RT, use immediate after mix) Dose: 30mcg IM once WEEKLY PRO: weekly dosing, low Nab, pre-filled syr, less inject run CON: efficacy < betaseron, IM, refrig req, most flu-like Sx
66
Rebif
RRMS Tx: Interferon Beta-1a Injection (Most common with Avonex) pre-filled syringe with injector Store in refridge Stable 30days at RT Dose: Target 44mcg SQ TIW* Titrate dose gradually PRO: pre-filled syr, titration pack available, efficacy> avonex, stable 30 days RT CON: high Nab, most LFT eleveation, refrig, TIW dosing
67
Betaseron
RRMS Tx: Interferon Beta-1b Injection (Powder and diluent for reconstitution) Store at RT; good for 3hr in refrige after mixing DOSE: 8million Units (0.25mg) SQ QOD Titrate dose gradually to min SE PRO: less stinging, no refrig, efficacy>avonex CON: QOD dose, mixing, highest NAb incidence
68
Extavia
RRMS Tx: Interferon Beta-1b Injection (Powder and diluent for reconstitution) Store at RT; good for 3hr in refrige after mixing DOSE: 8million Units (0.25mg) SQ QOD Titrate dose gradually to min SE
69
Glatiramer Acetate
RRMS & CIS Tx: Myelin AA mimic (divert immune system maybe MOA: unknown but get glatiramer-specific Th2 cells-antiinflammatory) Pre-filled injector syringes refrig store and 1 mo stable at RT Dose: 20mg SQ QDay SE: **Transient systemic post injection rxns= flushing, chest pain, palpitations, anxiety , dyspnea, constriction of the throat utricaria, diaphoresis, anxiety (Copaxone) PRO: no flu-like Sx, no labs, pre-filled syr, no Nabs CON: post inj-rxn, Qday, refrig, lowest efficacy
70
Fingolimod
MS Tx: 1st PO DMT: Sphingosine 1-Phosphate receptor modulation *inhibits t-cells migration out of lymph nodes Dose: 0.5mg PO Qday SE: inc risk of injection (influenza, *VZV, HSV) first dose bradycardia, chest pain, macular edema, resp, dysfn, Lots of Monitoring: CBC, *VZV vaccination, ECG, LFT, ophthalmic exam, 1st dose = 6hr vital signs in clinic monitoring D/c if serious infection, NO live vaccines, LFT q6-9mo,
71
Teriflunomide
MS Tx: PO DMT: active metabolite of leflunomide( a RA tx) - suppression of pyrimidine synthesis and down reg t/b cells **Add on to INF beta Dose: 7mg or 14mg PO Qday SE: PREGNANCY X, alopecia (Women consideration),
72
Dimethyl Fumarate
MS Tx: Recently approved PO DMT: AKA BG-12: induction of Th2-like cytokine and apoptosis in activated T-cell Dose:240mg PO BID (strat 120mg BID X 1wk)
73
Natalizumab
2nd line MS Tx PRO: no self inj, Good efficacy, well tolerated, Q.MO dosing CONS: unknown risk of PML, limited experience with drug, $$, TOUCH program, montherapy only
74
Mitoxantrone
2nd line MS Tx PRO: no self inj, good efficacy, infrequent dosing, some data to support as add-on Tx, least expensive, CON: infusion related SE, long term SE, lab and cardiac monitoring, no home admin, max lifetime dose
75
Dalfampridine SR
``` Tx of MS Sx, abulation problems: weak efficacy (clinical) ``` Dose 10mg PO BID Avoid renal dz and seizures
76
Sumatriptan
5-HT Agonist: Migraine (most dosage forms) Tab: 25, 50, 100mg @ onset; repeat 2hr (Max: 200mg/day) SL/needless inj (sumavel) 6mg SC @onset; repeat 1hr (max 12mg/day) **t-max = ~10min MAO Metabolism
77
Eletrip
5-HT Agonist: Migraine; most effective 20, 40mg @onset; repeat 2hr (max 80mg/day) 3A4 metabolism (strong interaction)
78
Frovatriptan
5-HT Agonist: Migraine; Longest duration Used as prophylaxis t1/2=26hrs 2.5mg @ onset; repeat 2hr (max 7.5mg/day) met-unchanged
79
Ergotamine
Migraine | 2mg SL @onset; repeat q30min (max 6mg/day, 10mg/weak)
80
Cafergot
Migraine: 1mg ergotomine; 100mg caffeine | 2 Tablets PO @onset; repeat q30min (max 6mg/day, 10mg/weak)
81
Dihydroergotamine
Migronal Spray: 1 sp. each nostril @onset; repeat 15 min (max 6sp/day, asp/wk) IM/SQ; 1mg (MAx 3mg/day, 6mg/wk)
82
Metoclopramide
Antiemetic for Migraine (inc ab of other migraine med too) 5mg at onset of migraine q46h prn DA Agonist = dystonic rxn PO, IM, IV (NO PR)
83
Trimethobenzamide
Antiemetic for Migraine: PO only (inhibits chemo-triger zone, less dystonic rxn) 300mg q6h prn
84
Promethazine
Antiemetic for Migraine: PO, IM, PR* | 25, 50mg q6h prn
85
Ketorolac
Migraine NSAID: (used in status migrainous) | 30mg IV q6hr

Therapeutics (10 decks)

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