Page 62 - Naplex Q&A 2025 Version

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metered-dose spray containing 230 metered sprays Vasopressin decreases the production of urine
of nitroglycerin. This product delivers 400 mcg of within 1 to 2 hours of administration and its
nitroglycerin per actuation in the form of spray duration of action lasts up to 12 to 16 hours.
droplets on or under the tongue. Nitromist is
indicated for acute relief of an attack or acute The recommended initial dose of Desmopressin for
prophylaxis of angina pectoris due to coronary patients age 6 years and older is 0.2 mg at bedtime.
artery disease. The dose may be titrated up to 0.6 mg to achieve
the desired response. Fluid restriction should be
At the onset of an attack, one or two metered observed, and fluid intake should be limited to a
sprays should be administered on or under the minimum from 1 hour before desmopressin
tongue. A spray may be repeated approximately administration, until the next morning, or at least 8
every 5 minutes as needed. No more than 3 hours after administration.
metered (NOT 5 metered) sprays are recommended
within a 15-minute period. If chest pain persists Headache, edema related weight gain, water
after a total of 3 sprays, prompt medical attention is intoxication and hyponatremia are reported side
recommended. Nitromist may be used effects of the drug.
prophylactically 5 to 10 minutes before engaging in
activities that might precipitate an acute attack. 122.(a) Anafranil (Clomipramine) is classified as a
tricyclic antidepressant (TCA). It is indicated for the
Headache, which may be severe and persistent, treatment of obsessive compulsive disorder.
may occur immediately after nitroglycerin use.
Postural hypotension, weakness, palpitation, Treatment with Anafranil should be initiated at a
flushing, drug rash and exfoliative dermatitis have dosage of 25 mg daily and gradually increased, as
been reported with Nitromist use. tolerated, to approximately 100 mg during the first
2 weeks. During initial titration, Anafranil should be
121.(b) Tofranil (Imipramine) is classified as a given in divided doses with meals to reduce
tricyclic antidepressant (TCA). It is indicated for the gastrointestinal side effects. Thereafter, the dosage
treatment of depression and nocturnal enuresis. may be increased gradually over the next several
weeks, up to a maximum of 250 mg daily. After
Initially, an oral dose of 25 mg/day should be tried titration, the total daily dose may be given once
in children aged 6 and older. Medication should be daily at bedtime to minimize daytime sedation.
given one hour before bedtime. If a satisfactory Anticholinergic side effects, Neuroleptic Malignant
response does not occur within one week, a Syndrome (NMS), tardive dyskinesia, hyperthermia
physician may increase the dose to 50 mg nightly in and seizure are reported side effects of
children under 12 years; children over 12 may Clomipramine.
receive up to 75 mg nightly. A daily dose greater
than 75 mg does not enhance efficacy and tends to Luvox (Fluvoxamine) is classified as an (Selective
increase side effects. Serotonin Reuptake Inhibitor). It is also indicated for
the treatment of obsessive compulsive disorder
Anticholinergic side effects, Neuroleptic Malignant (OCD). The recommended starting dose for Luvox
Syndrome (NMS), tardive dyskinesia and seizure are tablets in adult patients is 50 mg, administered as a
reported side effects of Imipramine. single daily dose at bedtime. In the controlled
clinical trials establishing the effectiveness of Luvox
Desmopressin (Vasopressin) is a synthetic analog of tablets in OCD, patients were titrated within a dose
endogenous human antidiuretic hormone. It is also range of 100 to 300 mg/day. Consequently, the
indicated for the treatment of nocturnal enuresis. dose should be increased in 50 mg increments every
Vasopressin produces its effect via binding to V2 4 to 7 days, as tolerated, until maximum
receptors present in a renal collecting duct. therapeutic benefit is achieved, not to exceed 300

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