Medication-overuse headache is generally classified as a:
a. Primary-headache b. Secondary-headache c. Tertiary-headache d. Category II-headache e. Category V-headache
Medication-overuse headache is generally classified as a:
a. Primary-headache b. Secondary-headache c. Tertiary-headache d. Category II-headache e. Category V-headache
Answer (b): Headaches are classified as primary or secondary according to the International Classification of Headache Disorders (ICHD) 2018.
Primary headaches are not caused by underlying illness. ICHD further classifies primary headaches as tension-type headache, migraine, trigeminal autonomic cephalalgias, or other primary headache disorders.
Secondary headaches are associated with an underlying condition (e.g., head injury or trauma, infection, stroke, substance withdrawal, or facial or cranial disorders).
Medication-overuse headaches are considered secondary by ICHD although they are not caused by an underlying disease (but are attributed to the withdrawal effect of analgesic medication).
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The simultaneous administration of which of the following with Qdolo is considered as a duplication of therapy?
a. Lopressor b. Humira c. Ultram d. Ritalin e. Levaquin
The simultaneous administration of which of the following with Qdolo is considered as a duplication of therapy?
a. Lopressor b. Humira c. Ultram d. Ritalin e. Levaquin
Answer: (c).
The active ingredient found in Qdolo is Tramadol hydrochloride. It is available as an oral solution. It is a schedule IV controlled substance. The simultaneous administration of Ultram (Tramadol) with Qdolo (Tramadol) is considered duplication of therapy; concurrent use should be avoided.
Qdolo is an opioid agonist indicated in adults for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. Start at 25 mg/day and titrate in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg four times a day). Thereafter the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg /day (50 mg four times a day). After titration, Qdolo 50 mg to 100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg/day.
Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for use in patients for whom alternative treatment options are inadequate; limit dosages and durations to the minimum required; and follow patients for signs and symptoms of respiratory depression and sedation.
Monitor patients closely for respiratory depression, especially within the first 24-72 hours of initiating therapy and following dosage increases with Qdolo and adjust the dosage accordingly.
The most common incidence of treatment-emergent adverse events in patients from clinical trials were dizziness/vertigo, nausea, constipation, headache, somnolence, vomiting and pruritus.
Which of the following statements is/are TRUE ABOUT Spravato? [Select ALL THAT APPLY].
a. It is indicated for the treatment of treatment-resistant depression. b. Lketamine is its active ingredient. c. It is a schedule IV controlled substance. d. It is a non-competitive N-methyl D-aspartate (NMDA) receptor antagonist. e. It is available as a nasal spray.
Which of the following statements is/are TRUE ABOUT Spravato? [Select ALL THAT APPLY].
a. It is indicated for the treatment of treatment-resistant depression. b. Lketamine is its active ingredient. c. It is a schedule IV controlled substance. d. It is a non-competitive N-methyl D-aspartate (NMDA) receptor antagonist. e. It is available as a nasal spray.
Answer: (a,d,e)
The active ingredient found in Spravato is Esketamine. It is available in a nasal spray. It is a schedule III controlled substance.
Spravato is a non-competitive N-methyl D-aspartate (NMDA) receptor antagonist indicated, in conjunction with an oral antidepressant, for the treatment of:
1. Treatment-resistant depression (TRD) in adults.
2. Depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior.
Spravato is administered intranasally under the supervision of a healthcare provider.
The recommended dosage of Spravato (Esketamine) for the treatment of depressive symptoms in adults with MDD with acute suicidal ideation or behavior is 84 mg twice per week for 4 weeks. Dosage may be reduced to 56 mg twice per week based on tolerability.
Spravato (Esketamine) is for nasal use only. The nasal spray device delivers a total of 28 mg of Esketamine. To prevent loss of medication, do not prime the device before use. Use 2 devices (for a 56 mg dose) or 3 devices (for an 84 mg dose), with a 5-minute rest between use of each device.
Dissociation, dizziness, nausea, sedation, vertigo, hypoesthesia, anxiety, lethargy, blood pressure increased, vomiting, and feeling drunk are commonly reported side effects of Spravato.
Because of the risks for sedation, dissociation, and abuse and misuse, Spravato (Esketamine) is only available through a restricted program called the Spravato (Esketamine) Risk Evaluation and Mitigation Strategy (REMS) Program.
Spravato (Esketamine) can only be administered at healthcare settings certified in the Spravato (Esketamine) REMS Program and to patients enrolled in the program.
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Kesimpta (Ofatumumab) is indicated for the treatment of:
a. Hypertension b. Gout c. Multiple sclerosis d. Type II diabetes e. Parkinsonism
Kesimpta (Ofatumumab) is indicated for the treatment of:
a. Hypertension b. Gout c. Multiple sclerosis d. Type II diabetes e. Parkinsonism
The active ingredient found in Kesimpta is Ofatumumab. It is available in a single-dose prefilled syringe.
Kesimpta (Ofatumumab) is a CD20-directed cytolytic antibody indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.
The precise mechanism by which Ofatumumab exerts its therapeutic effects in multiple sclerosis is unknown, but is presumed to involve binding to CD20, a cell surface antigen present on pre-B and mature B lymphocytes. Following cell surface binding to B lymphocytes, ofatumumab results in antibody-dependent cellular cytolysis and complement-mediated lysis.
Hepatitis B virus (HBV) and quantitative serum immunoglobulins screening are required before the first dose.
Initial Dosing: 20 mg subcutaneously administered at Week 0, 1, and 2.
Respiratory tract infection, headache, injection-related reactions, and local injection site reactions are reported side effects of drug.
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What is a strain number of influenza virus in A/Texas/50/2012 (H3N2)?
a. A b. Texas c. 50 d. 2012 e. H3N2
What is a strain number of influenza virus in A/Texas/50/2012 (H3N2)?
a. A b. Texas c. 50 d. 2012 e. H3N2
Answer: (c) Influenza is named according to the type, the location of initial isolation, the strain designation, and the year of isolation. For example, A/Texas/50/2012 (H3N2), or H3N2, is influenza type A with origin in Texas, with strain No. 50, isolated in 2012 and of the H3N2 subtype.
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Botox (OnabotulinumtoxinA) inhibits the release which of the following?
a. Serotonin b. Histamine c. Acetylcholine d. GABA e. Dopamine
Botox (OnabotulinumtoxinA) inhibits the release which of the following?
a. Serotonin b. Histamine c. Acetylcholine d. GABA e. Dopamine
The active ingredient found in Botox is OnabotulinumtoxinA. It is an acetylcholine release inhibitor and a neuromuscular blocking agent.
Botox (OnabotulinumtoxinA) blocks neuromuscular transmission by binding to acceptor sites on motor or autonomic nerve terminals, entering the nerve terminals, and inhibiting the release of acetylcholine. This inhibition occurs as the neurotoxin cleaves SNAP-25, a protein integral to the successful docking and release of acetylcholine from vesicles situated within nerve endings.
When injected intramuscularly at therapeutic doses, Botox (OnabotulinumtoxinA) produces partial chemical denervation of the muscle resulting in a localized reduction in muscle activity. In addition, the muscle may atrophy, axonal sprouting may occur, and extrajunctional acetylcholine receptors may develop. There is evidence that reinnervation of the muscle may occur, thus slowly reversing muscle denervation produced by Botox (OnabotulinumtoxinA).
When injected intradermally, Botox (OnabotulinumtoxinA) produces temporary chemical denervation of the sweat gland resulting in local reduction in sweating.
Following intradetrusor injection, Botox (OnabotulinumtoxinA) affects the efferent pathways of detrusor activity via inhibition of acetylcholine release.
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I. a persistent headache II. swelling of the face or hands III. shoulder pain
a. I only b. I and II only c. II and III only d. All
What are signs and symptoms of preeclampsia?
I. a persistent headache II. swelling of the face or hands III. shoulder pain
a. I only b. I and II only c. II and III only d. All
Answer: (d) All. Preeclampsia is a condition during pregnancy where there is a sudden rise in blood pressure and swelling, mostly in the face, hands, and feet.
Signs and symptoms associated with preeclampsia:
1. a headache that persists 2. swelling of the face or hands 3. changes in eyesight 4. sudden weight gain 5. shoulder pain 6. nausea and vomiting
Which of the following information is/are TRUE ABOUT headaches during menstrual period? [Select All That Apply]
a. A menstrual migraine headache may occur before, during, or after a period. b. Acute migraine headaches may occur when the level of estrogen in the body rises significantly. c. Around 10% of females who experience migraine report that menstruation is a trigger for these headaches. d. Premenstrual syndrome headaches typically occur before a period begins. e. Sensitivity to bright lights and noise is also reported with the menstrual migraine.
Which of the following information is/are TRUE ABOUT headaches during menstrual period? [Select All That Apply]
a. A menstrual migraine headache may occur before, during, or after a period. b. Acute migraine headaches may occur when the level of estrogen in the body rises significantly. c. Around 10% of females who experience migraine report that menstruation is a trigger for these headaches. d. Premenstrual syndrome headaches typically occur before a period begins. e. Sensitivity to bright lights and noise is also reported with the menstrual migraine.
Answer: (a, d and e).
A menstrual migraine headache may occur before, during, or after a period whereas premenstrual syndrome (PMS) headaches typically occur before a period begins.
Acute migraine headaches are normally reported when the level of estrogen in the body drops (not rises) significantly.
Around 60% (not 10%) of females who experience migraine report that menstruation is a trigger for these headaches.
Other symptoms of a menstrual migraine headache tend to include:
1. sensitivity to bright lights 2. sensitivity to noise 3. throbbing pain on one side of the head 4. nausea 5. vomiting