Dr Bob’s Favorite Things

Codes for messaging:
N – New (eg: N: Smith, John)
F – Follow Up (eg: F: Smith, John)
C – Carpal Tunnel Injection (eg: C: Smith, John)
B – Botox Injection (eg: B: Smith, John)
E – EMG (eg: E: Smith, John)
T – Telemedicine – new one, no longer ‘V’ (eg: T: Smith, John)
V – Vaccinated – new one, was for video before). (eg: VN: or VC: or VE:, etc.)
L – Last patient of the wave (eg: LVN: or LF: or LT: etc.)

Inexpensive Medications (Cash Only): CostPlus Drugs
https://costplusdrugs.com/medications

Favorite Carpal Tunnel Mueller Fitted Wrist Brace:
Right Hand: https://amzn.to/2VHJ20c
Left Hand: https://amzn.to/3kaY4Fi

Preferred Ankle Foot Orthosis:
Neofect https://amzn.to/3D4MPWw
Aider https://amzn.to/3Jxhizh

Heelbo Elbow Protector (for Tardy Ulnar Palsy)
https://amzn.to/3DIX2bM

Wheelchairs, DME
https://www.firststatedme.com

Prosthetics and Orthotics – Lawall
https://www.lawall.com

Waking Up with Sam Harris
https://dynamic.wakingup.com/shareOpenAccess/30dayemail
This is the real deal Vipassana Meditation training with a 30 day free trial.
Must commit to daily use for a month.

Vipassana 10-Day Meditation Program in Claymont, DE
https://www.dhamma.org/en-US/schedules/schpubbananda

Meditation App Review (more ‘new-age’ programs)
https://www.medicalnewstoday.com/articles/best-meditation-apps

How We Feel (get in touch with yourself)
https://howwefeel.org

Sleep/Anxety Meditation App:
https://breethe.com/
They have a 2 week trial. If you cancel before the trial, they’ll come back at you with a 30% discount for those that want to continue to use.

Want to Fall Asleep in 2 minutes?
https://link.medium.com/UsGnM2s6snb

CDBT for insomnia Cleveland Clinic ($40)
https://www.clevelandclinicwellness.com/Pages/GoToSleep.htm

Podcast: Understanding Sleep and How to Improve It
https://cnmri.com/2022/09/05/understanding-sleep-and-how-to-improve-it/

Matt Walker on Sleep, the Body and the Brain
https://themattwalkerpodcast.buzzsprout.com
Overcast Direct Link: https://overcast.fm/itunes1578319619

Snore Guard for Mild Sleep Apnea
https://amzn.to/3xRwu5I

Somnifix Mouth Strips
https://amzn.to/3tVhjHg

Inspire for Sleep Apnea
https://professionals.inspiresleep.com/indications-contraindications/

Dr. Jagdeep Hundal – ENT Surgeon for Inspire
https://entad.org/our-physicians/jagdeep-hundal-md/

TMJ Expert – Dr Barry Kayne
https://www.delawareperio.com/orofacial-pain/

Treating Low Back Pain
https://www.vox.com/science-and-health/2017/8/4/15929484/chronic-back-pain-treatment-mainstream-vs-alternative

Diet & Nutrition Myths & Fact (Give link to patients)
https://cnmri.com/diet-nutrition-fact-fiction/

Soda/soft drink altenatives (stay away from fructose!)
https://www.levelshealth.com/blog/13-soda-alternatives-less-likely-to-spike-your-blood-sugar

Intermittent Fasting Apps (Zero, etc.)
https://www.goodhousekeeping.com/health-products/g34618367/best-apps-intermittent-fasting/

LactMed – Drugs and Lactation Database:
https://www.ncbi.nlm.nih.gov/books/NBK501922/

Brain Games for MCI/Alzheimer’s
https://apps.apple.com/us/story/id1310609381

The Complete Guide to Memory
https://smile.amazon.com/Complete-Guide-Memory-Science-Strengthening-ebook/dp/B09JPFXHD8

Smart Lock (control with smartphone or keypad)
Lock: https://amzn.to/3v0WI5w
Keypad: https://amzn.to/3EudQUj

Neuropsych Directories:
https://theaacn.org/view/member-directory/?filter_13%5B%5D=Delaware&filter_14%5B%5D=&filter_9%5B%5D=&filter_12=&filter_7_3=&filter_1=&mode=all
https://www.abpp.org/Directory

Mental Health/Substance Abuse Treatment Facilities:
https://www.treatmentconnection.com/search-treatment-facilities

Home Video Camera for Patients with Dementia
Wyze Cam Pan Camera: https://amzn.to/3KzTnzz

Tadasana Yoga for Syncope:
https://www.mdedge.com/cardiology/article/251291/hypertension/yoga-maneuver-may-prevent-vasovagal-syncope
https://www.medscape.com/viewarticle/967513

Tadasana Maneuver Instructions:
https://www.yogajournal.com/poses/mountain-pose/

Polarized Dark Sunglasses:
https://amzn.to/3zWNeco
https://amzn.to/3I6d94b

Polarized “Low-Light” Sunglasses:
https://www.amazon.com/dp/B07DFXHTDB
https://www.amazon.com/dp/B07MQSPJRJ

Apple Accessibility (Vison, Hearing, Mobility, Cognitive)
https://www.apple.com/accessibility/

Apple Audio Accessibility
https://www.apple.com/accessibility/hearing/

Tinnitus Noise Masker
https://apps.apple.com/us/app/odio-ar-soundscapes/id1556016869

Neosensory Duo for Tinnitus
https://neosensory.com/product/neosensory-duo-for-tinnitus/

Galantamine Tablet Forms:
The ‘ER’ version in 8, 16 and 24 mg, which we rarely use due to insurance issues is QD
The ‘regular’ version in 4, 8 and 12 mg is BID

Parkinson’s Exercise/Boxing Program
http://rocksteadyboxing.org

Skin Biopsy for Parkinson’s
CND Syn-One test – https://cndlifesciences.com/syn-one-test/

Blood Test for Alzheimer’s
Preclivity – https://precivityad.com

Doctors to Refer to:
Sudhakar Satti, MD – Christiana Neurointerventional
https://doctors.christianacare.org/provider/Sudhakar+R.+Satti/844944

MEDICATIONS: Doses, Directions, Side Effects, classification

MIGRAINE PREVENTIVE:

Aimovig (erenumab-aooe) 70mg (migraine)
Inject once monthly (may need to go to 140mg monthly)
SE: Injection site reaction and constipation.

Elavil (amitriptyline) 10mg qhs (antidepressant/migraine)
1-3 tablets q hs
SE: Fast heart rate, blurred vision, urinary retentions, dry mouth, weight gain or loss, constipation, low blood pressure, rash, hives, seizures.

Elavil (amitriptyline) 25mg qhs (antidepressant/migraine)
1-3 tablets q hs
SE: Fast heart rate, blurred vision, urinary retentions, dry mouth, weight gain or loss, constipation, low blood pressure, rash, hives, seizures.

Emgality (galcanezumab) 120mg (migraine)
Inject two (240mg) for initial dose then 1 injection q month
SE: allergic reactions, such as itching, rash, hives, and trouble breathing.

Desyrel (trazodone) 50mg (antidepressant/migraine)
Trazodone 50mg 1/2 po qhs x 2 weeks then 1 po qhs x 2 weeks then 1 1/2 qhs x 2 weeks then 100mg qhs.
SE: blurred vision, dizziness, drowsiness, headache, nausea, vomiting, and xerostomia.

Effexor (venlafaxine) (antidepressant/migraine)
Effexor XR 37.5mg 1 tablet daily for 7 days; then Effexor 75mg 1 tablet daily.
SE: Nausea, drowsiness, dizziness, dry mouth, constipation, loss of appetite, blurred vision, nervousness, trouble sleeping, unusual sweating, or yawning may occur. If any of these effects persist or worsen, tell your doctor promptly. This medication may raise your blood pressure.

Prozac (fluoxetine) 20mg (antidepressant/migraine)
Take one time daily
SE: decreased appetite, anxiety and nervousne, weakness, diarrhea, dry mouth, indigestion, flu, erectile dysfunction (trouble getting or keeping an erection), trouble sleeping, nausea, sore throat, rash, watery nasal discharge, sleepiness, sweating and hot flashes, tremors (uncontrollable rhythmic movement in one part of your body), yawning, strange dreams, decreased sex drive and trouble having an orgasm

Lexapro (escitalopram)10mg (antidepressant/migraine)
Take one time daily
SE:agitation, hallucinations (seeing or hearing things that aren’t real), coma (loss of consciousness), coordination problems, overactive reflexes, or muscle twitching, racing heart rate, high or low blood pressure, sweating or fever, nausea, vomiting, or diarrhea, muscle stiffness.

Paxil (paroxetine HCI) 10mg (antidepressant/migraine)
Take one time daily
SE: Nausea, drowsiness, dizziness, trouble sleeping, loss of appetite, weakness, dry mouth, sweating, blurred vision, and yawning may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Inderal (Propranolol) 20mg (betablocker)
Take one twice daily two weeks then two (40mg) twice daily
SE: feeling tired, dizzy or light headed (these can be signs of a slow heart rate) cold fingers or toes (propranolol may affect the blood supply to your hands and feet) difficulties sleeping or nightmares. feeling sick (nausea).

Tenormin (Atenolol) 25mg (betablocker)
1 qd; may increase to 50 mg qd if directed by doctor.
SE: (rare) abdominal cramping, diarrhea, constipation, fatigue, insomnia, nausea, depression, dreaming, memory loss, fever, lightheadedness, slow heart rate, low blood pressure, numbness, tingling, cold extremities, sore throat.

Topamax 25mg (topiramate) (antiseizure/migraine)
1 tablet at bedtime for 7 days, then 2 tablets at bedtime for 7 days, then 3 tablets at bedtime for 7 days then 100mg at bedtime there after (quantity: #42 of the 25mg and #30 of the 100mg)
SE: Burning or tingling, dizziness, fatigue, drowsiness, nervousness, coordination problems, weight loss, loss of appetite, taste change, confusion, difficulty concentration or attention, nausea

Zoloft 50mg (sertraline) (antidepressant/migraine)
Take one time daily
SE: Common: nausea, vomiting, insomnia, dry mouth, dyspepsia, anxiety, sexual dysfunction. Less common: drowsiness, headache, loss of appetite, weakness, diarrhea.

Verapamil ER 180mg (calan sr) (calcium channel blocker)
one po qhs
SE: Dizziness, slow heartbeat, constipation, stomach upset, nausea, headache, or tiredness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Wellbutrin 150mg (bupropion) (antidepressant/migraine)
1 tablet qam x 14 days; then 2 tablets qam
SE: headache, weight loss, dry mouth, trouble sleeping, nausea, dizziness, constipation, fast heartbeat, and sore throat.

Zonegran (Zonisamide) 25mg (antiseizure/migraine)
1 po qhs x 1 week then 2 po qhs x 1 week then 3 po qhs x 1 week then 100mg q hs there after. (quantity: #42 of the 25mg and #30 of the 100mg)
SE: Fatigue, dizziness, loss of appetite, headache, agitation, poor coordination, speech problems, itching, vision problems.

MIGRAINE ABORTIVE MEDICATIONS

Amerge (naratriptan): 1mg/2.5mg (headache)
2.5 mg tablet onset of headache; may repeat in four hours if needed; limit of 2 tablet per twenty-four hours or 4 tablets per week
SE: Nausea, dry mouth, tingling, burning, dizziness, drowsiness, throat or neck symptoms, warm or cold sensations, heaviness or pressure or tightness in the throat, chest or neck, flushing of the skin.

Axert (almotriptan): 6.25mg/12.5mg (headache)
12.5 mg tablet onset of headache, may repeat in two hours if needed. Limit of 2 tablets per 24 hours or 4 tablets per week
SE: dizziness, somnolence, headache, paresthesia, nausea, and vomiting

Anaprox DS (diclofenac potassium): 50mg (headache)
One 2-3 times daily as needed
SE: Upset stomach, nausea, heartburn, diarrhea, constipation, gas, headache, drowsiness, and dizziness

Fioricet (butalbital/actaminophen/caffeine) (headache)
(NO dose amount) 1-2 q 4 to 6 hours prn Maximum of 7 per week
SE: Nausea, vomiting, abdominal pain, constipation, dry mouth, shaking (tremor), shortness of breath, increased urination, lightheadedness, dizziness, drowsiness, or trouble sleeping

Frova 2.5mg: (frovatriptan) (headache)
1 tablet onset of headache, may repeat in two hours if needed. Limit of 2 tablets per 24 hours or 4 tablets per week
SE: Nausea, dry mouth, tingling, burning, dizziness, drowsiness, throat or neck symptoms, warm or cold sensations, heaviness or pressure or tightness in the throat, chest or neck, flushing of the skin.

Imitrex (sumatriptan succinate): 25, 50 or 100mg (headache)
100 mg tablet at onset of headache, may repeat in two hours if needed. Limit of 2 tablets per 24 hours or 4 tablets per week
SE: Tingling, burning, pressure tightness, numbness, bad taste in mouth, dizziness, flushing (redness to skin), chest tightness or pressure, weakness and neck pain, drowsiness, anxiety, jaw pain, sweating.

Imitrex injection 4mg (sumatriptan) (headache)
1 subcutaneous injection prn headache may repeat in 2-3 hours. Limited to 2/day or 4/week. # 2 to 3 boxes (6 each box) with refills
SE: Nausea, dry mouth, tingling, burning, dizziness, drowsiness, throat or neck symptoms, warm or cold sensations, heaviness or pressure or tightness in the throat, chest or neck, flushing of the skin.

Imitrex NS 20mg (headache)
One spray in one nostril at onset of headache, may repeat in 90 minutes. Limit of 2 spray per 24 hours or 4 sprays per week
SE: Tingling, burning, pressure tightness, numbness, bad taste in mouth, dizziness, flushing (redness to skin), chest tightness or pressure, weakness and neck pain, drowsiness, anxiety, jaw pain, sweating.

Maxalt (rizatriptan): 5 mg/10mg (headache)
1 tablet onset of headache; may repeat in two hours if needed; limit of 2 tablets per twenty-four hours or 4 tablets per week
SE: Nausea, dry mouth, tingling, burning, dizziness, drowsiness, throat or neck symptoms, warm or cold sensations, heaviness or pressure or tightness in the throat, chest or neck, flushing of the skin.

Maxalt MLT (rizatriptan): 5mg/10 mg (headache)
place one wafer onset of headache (place wafer on tongue and swallow saliva); may repeat in two hours if needed; limit of 2 tablets per twenty-four hours or 4 tablets per week
SE: Chest pain, dizziness, drowsiness, dry mouth, fatigue, nausea, pain, tingling of the skin and weakness.

Migranal nasal spray 4mg/ml (dihydroergotamine) (headache)
1mg one spray in each nostril at onset of headache, repeat in 15 minutes. Limit of 2 spray per 24 hours or 4 sprays per week
SE: Nausea, vomiting, diarrhea.

Nurtec ODT (rimegepant) 75mg (headache)
Take at onset of headache (max one per day, 15 per month)
SE: allergic reactions, including trouble breathing and rash

Oxygen (headache)
DME: 100% Oxygen by mask: breathe 100% oxygen by mask @ 7L per minute, for 15 minutes for headaches. **Needs diagnosis code: Headaches.

Phenergan (promethazine) (nausea/headache)
Phenergan 25mg take one tablet by mouth every 8 hours prn for nausea
SE: severe drowsiness, weak or shallow breathing; a light-headed feeling, like you might pass out; confusion, agitation, hallucinations, nightmares; seizure (convulsions); fast or slow heartbeats; jaundice (yellowing of the skin or eyes).

Relpax (eletriptan HBr): 20mg/40mg (headache)
1 tablet onset of headache, may repeat in two hours if needed. Limit of 2 tablets per 24 hours or 4 tablets per week
SE: Dizziness, drowsiness, dry mouth, flushing, headache, nausea, sleepiness.

Toradol 10mg (ketolalac) (headache)
20 mg once after IV or IM therapy, THEN 10 mg q4-6hr; not to exceed 40 mg/day
SE: Diarrhea, dizziness, drowsiness, headache, indigestion, nausea, stomach and intestinal pain, swelling due to fluid retention

Treximet (headaches) 85/500mg (headache)
1 tablet onset of headache; may repeat in two hours if needed; limit of 2 tablets per twenty-four hours or 4 tablets per week
SE: Nausea, dry mouth, tingling, burning, dizziness, drowsiness, throat or neck symptoms, warm or cold sensations, heaviness or pressure or tightness in the throat, chest or neck, flushing of the skin.

Ubrelvy (ubrogepant) 50 or 100mg (headache)
Take onset of headache, may repeat in two hrs. Max 200mg/24 hours.
SE: Drowsiness, sleepiness, dry mouth.

Zomig (zolmitriptan): 2.5 mg/5 mg (headache)
1 tablet onset of headache; may repeat in two hours if needed; limit of 2 tablets per twenty-four hours or 4 tablets per week
SE: Nausea, dry mouth, tingling, burning, dizziness, drowsiness, throat or neck symptoms, warm or cold sensations, heaviness or pressure or tightness in the throat, chest or neck, flushing of the skin.

Zomig NS: 5mg (headache)
1 spray in 1 nostril at onset of headache, may repeat in 90 minutes. max 2 per day or 4 per week
SE: Nausea, dry mouth, tingling, burning, dizziness, drowsiness, throat or neck symptoms, warm or cold sensations, heaviness or pressure or tightness in the throat, chest or neck, flushing of the skin.

Zomig ZMT: (headache)
Place one wafer on tongue and swallow saliva at onset of dache, may repeat in two hours if needed. Limit of 2 per 24 hours or 4 tablets per week
SE: Unusual taste, dizziness, tingling, burning, neck pain, jaw pain, throat pain, weakness, nausea, drowsiness, warm or cold sensations..

SEIZURE MEDICATIONS:

Carbatrol (carbamazepine)300mg (seizure/trigeminal neuralgia)
1 PO twice daily
SE: nausea, vomiting, drowsiness, dizziness, dry mouth, swollen tongue, loss of balance, unsteadiness.

Depakote (divalproex sodium) 500mg (seizure)
1 PO bid
SE: Fatigue, dizziness, upset stomach, vomiting, tremor, hair loss, weight gain, changes in behavior (depression).

Dilantin (phenytoin) seizures 100mg (seizure)
3 capsules twice daily
SE: Dizziness, headache, nausea, constipation, vomiting. Severe: hives, rash, difficulty breathing, tightness in the chest, clumsiness, confusion, hight blood sugar, numbness and tingling of the hands and feet

Keppra (levetiracetam) 500mg/750mg/1000mg/1500mg (seizure)
One po twice daily (titration: 250mg 1 PO qd x 7 days, then bid x 7 days, 500mg bid x 7 days then 750mg 1 PO bid.) Usual dose is 500mg bid.
SE: Decreased appetite, dizziness, drowsiness, generalized weakness, headache, increased eosinophils in the blood, irritability, low energy, stuffy nose, throat irritation.

Klonopin (clonazepam) 0.5mg (seizure)
Take for seizure aura max bid
SE: drowsiness, upper respiratory tract infection, ataxia, depression, and dizziness.

Lamotrigine
With enzyme-inducing AEDs but without valproic acid
Initial: 50 mg PO qDay for 2 weeks, THEN
100 mg/day divided q12hr for 2 weeks
At week 5 and beyond, may increase by 100 mg/day PO q1-2Week to 300-500 mg/day PO divided q12hr
With valproic acid
Initial: 25 mg PO qODay for 2 weeks, THEN
25 mg PO qDay for 2 weeks
At 5 weeks may increase by 25-50 mg/day q1-2Week to 100-400 mg/day qDay or divided q12hr
Without enzyme-inducing AEDs or valproic acid
Initial: 25 mg PO qDay for 2 weeks, THEN
50 mg/day PO for 2 weeks
After 4 weeks may increase by 50 mg/day q1-2Week to 225-375 mg/day divided q12hr

Lyrica (pregabalin) 50mg *Controlled (seizure/neuropathic pain)
Lyrica 50mg 1 bid x 1 week
Lyrica 100mg 1 bid x 1 week if no benefit
Lyrica 150mg 1 bid.
SE: Common: dizziness, imbalance, fatigue, sleepiness. Less common: weakness, double or blurred vision, trouble concentrating, nausea, tremor, headache, confusion.

Tegretol (carbamazepine USP) (seizure/trigeminal neuralgia)
Tegretol 200mg 1 tablet bid
SE: nausea, vomiting, drowsiness, dizziness, dry mouth, swollen tongue, loss of balance, unsteadiness.

Vimpat (lacosamide) 50mg *Controlled (seizure)
1 po bid x 1 week then 2 po bid thereafter.
SE: double vision, headache, dizziness, nausea, vomiting, tiredness, balance problems.

Zonagran (Zonisamide) 25mg (quantity 42) (seizure)
Week 1 – 25mg 1 po qhs
Week 2 – 25mg 2 PO qhs
Week 3 – 25mg 3 PO qhs
Week 4 – 100mg 1 po qhs
Week 5 – 100mg 1 Po qhs
Week 6 – 100mg qam and qhs
Week 7 – 100mg 2 qam and 2 qhs (200mg bid this will be therapeutic dose).
SE: Fatigue, dizziness, loss of appetite, headache, agitation, poor coordination, speech problems, itching, vision problems.

PARKINSON/ALS MEDICATIONS:

Azilect 0.5mg(rasagiline) (MAO inhibitor, Parkinson)
Take one daily x 1-2 weeks then 1.0mg qd
SE: dizziness, spinning sensation, joint pain, headache, depression, heartburn, nausea, fever.

Requip (ropinirole) 1mg (dopamine agonist, Parkinson/RLS)
Take once daily at bedtime
SE: Dizziness, nausea, headache.

Rilutek (Treatment for ALS) 50mg (benzothiazole, Parkinson)
Take one bid
SE: Dizziness, lightheadedness, drowsiness, tiredness, nausea, vomiting, diarrhea, loss of appetite, stomach pain, or numbness/tingling around the mouth.

Sinemet CR (carbidopa-leodopa) 50/200 (decarboxylase inhibitorParkinson)
1 tablet bid; may titrate to tid
SE: Drowsiness, dizziness, headache, loss of appetite, nausea, vision changes, trembling of the hands.

Sinemet (carbidopa-leodopa) 25/100mg (decarboxylase inhibitorParkinson)
1 tablet TID-QID (or more sometimes).
SE: Drowsiness, dizziness, headache, loss of appetite, nausea, vision changes, trembling of the hands.

DEMENTIA MEDICATIONS:

Aricept (donepezil HCI) (dementia)
5mg q hs X one month then 10mg ohs. Give prescription for 5mg #30 no refills and prescription for 10mg.
SE: Diarrhea, muscle cramps, depression, fainting.

Exelon (rivastigmine tartrate)1.5mg: (dementia)
1 tablet once daily for 2 weeks, then 1 tablet twice daily for 2 weeks, then one 1.5mg in morning and 3mg in evening for 2 weeks then 3mg twice daily there after.

Exelon patches 9.5/24 hours (dementia)
Remove old patch and apply new patch qd.
SE: Nausea, vomiting, loss of appetite/weight loss, diarrhea, weakness, dizziness, drowsiness, and shakiness (tremor) may occur as your body adjusts to the drug.

Haldol (haloperidol) 0.5mg (dementia/antipsychotic)
1 PO qam (breakfast) and 1 PO qpm (dinner)
SE: Common: blurred vision, changes in menstrual period, constipation, dryness of the mouth, swelling or pain in the breasts, weight gain.
Less common: decreased sexual ability, drowsiness, increased sensitivity to the sun, nausea and vomiting.

Namenda (memantine) 5mg (dementia)
Take one qd X one week then bid X one week then 2 am 1pm X one week then 2 bid.
SE: Common: nausea, vomiting, diarrhea, constipation, loss of appetite, dizziness, fatigue, weight loss, swelling of hands and feet, fast heart rate, easy bruising or bleeding, joint pain, anxiety, skin rash, frequent urination.
Less common (serious):Chest tightness, cough, fever, trouble breathing, fast heart rate, confusion, hallucinations, numbness and weakness, lack of coordination, fainting or seizures.

Razadyne ER (galantamine HBr ER) 8mg (dementia)
1 po daily x 1 month (then increase to 16mg daily).
SE: Nausea, diarrhea, increased frequency of bowel movements, vomiting, loss of appetite, weight loss

Risperdal (risperidone) 1mg (dementia/antipsychotic)
1 tablet bid (12 pm and qhs)
SE: Constipation, coughing, diarrhea, drowsiness, dry mouth, headache, heart burn, nausea, sore throat, stuffy or runny nose, fatigue, weakness, weight gain, increased dream activity.

Seroquel (quetiapine) 25mg (dementia/antipsychotic)
1 po qd x 2 weeks then may increase to 50mg qd
SE: mood or behavior changes, constipation, stomach pain, upset stomach, nausea, vomiting, drowsiness, dizziness.

MULTIPLE SCLEROSIS MEDICATIONS:

Copaxone (glatiramer acetate) 20mg (enrollment form) (MS)
injected subcutaneously daily.
SE: include redness, pain, swelling, itching, or a lump at the injection site; rash; shortness of breath; flushing; and chest pain.

Prednisone 20mg (MS exacerbation)
4 qd x 3 days then 3 qd x 3 days then 2 qd x 3 days then 1 qd x 3 days then 1/2 qd x 3 days then 1/2 qod x 3 days then stop (35 pills).
SE: Nausea, vomiting, loss of appetite, heartburn, trouble sleeping, increased sweating, or acne.

Rebif (interferon Beta 1a) 44mcg (enrollment form) (MS)
inject subcutaneously 3 times weekly
SE: Pain, swelling, or redness at the injection site. Flu-like symptoms such as headache, dizziness, fatigue, fever, chills, stomach pain, runny or stuffy nose, and muscle aches.

Solu medrol (MS exacerbation)
Solumedrol 1.0gram IV x 3 days then Prednisone 20mg 4 qd x 3 days then 3 qd x 3 days then 2 qd x 3 days then 1 qd x 3 days then 1 qod x 3 days then discontinue.

Solu Medrol 1,000mg (MS exacerbation)
Infuse 1000mg slowly over 2-3 hours once daily for 3 days.
SE: Nausea, vomiting, heartburn, headache, dizziness, trouble sleeping, appetite changes, increased sweating, acne, or pain/redness/swelling at the injection site

Tysabri (enrollment form) (MS)
Tysabri Dose: 300mg Quantity: IV infusion
One IV infusion every 4 weeks
SE: Headache, urinary tract infection, lung infection, pain in your arms and legs, vaginitis, stomach-area pain, feeling tired, joint pain, depression, diarrhea, rash, nose and throat infections, and nausea.

OTHER MEDICATIONS:

Ambien 10mg (zolpidem tartrate) (benzodiazepine, sleep)
One PO hs prn (no more than 3 per week)
SE: Headache, drowsiness, dizziness, diarrhea, dry mouth.

Antivert (meclizine) 25mg (atiemetic, nausea)
1 -2 bid as needed for dizziness
SE: Nausea, vomiting, drowsiness, dizziness, dry mouth, constipation, headache, tiredness.

Ativan 1mg (lorazepam) (benzodiazepine, anxiety)
Take one bid prn
SE: Confusion, lack of muscle control, blood in urine or stool, stomach pain, weight loss, tremors, overdose, addiction.

Cymbalta 30mg (duloxetine HCI) (SNRI, depression and pain)
One daily for 2 weeks then two daily.
SE: Nausea, drowsiness, headaches, dry mouth, dizziness, insomnia, constipation, fatigue, diarrhea.

Diamox (acetazolamide) (carbonic anhydrase inhibitor/papilledema)
Diamox 250mg 1 PO bid
SE: Blurred vision, dry mouth, drowsiness, loss of appetite, nausea, vomiting, diarrhea, or changes in taste.

Doxycycline (treat lyme disease)
Doxycycline 100mg 1 po bid x 3 weeks #42 with no refills.
SE: Diarrhea, difficulty swallowing, drug rash, esophageal ulcer, esophagitis, facial redness, headache, hives.

Focalin XR (dexmethylphenidate hydrochloride) 10 or 20mg *controlled (ADD, narcolepsy, fatigue in MS)
Take once daily
SE: Trouble sleeping, nervousness, dizziness, dry mouth, heartburn, nausea, stomach pain, headache, loss of appetite, or weight loss

Flexeril (cyclobenzaprine HCI) (muscle relaxer )
Flexeril 10mg 1 PO bid prn
SE: Dry mouth, headache, blurred vision, drowsiness, fatigue, loss of appetite, stomach pain.

Lidoderm Patch (lidocaine) 5% (pain)
1 patch 12 hours per day
SE: Burning, stinging, irritation, swelling, redness, confusion, drowsiness, dizziness, blurred vision, tinnitus.

Mestinon (pyridostigmine) 60mg (cholinesterase inhibitor, myasthenia gravis)
1/2 tablet tid
SE: Diarrhea, excessive saliva, excessive sweating, nausea, stomach cramps, vomiting.

Mirapex (pramipexole) (dopamine antagonist/parkinson)
0.125mg qhs x 3 days then 0.25mg qhs x 3 days then 0.50mg qhs.
SE: Dizziness, nausea, dry mouth, stomach pain, vomiting, constipation, headache, dizziness.

Motrin (Ibuprofen) 400mg (NSAID)
1 po q4hrs prn pain #30 with refills.
SE: Upset stomach, nausea, vomiting, headache, diarrhea, constipation, dizziness, or drowsiness

Mysoline (primidone) 50mg (barbiturate anticonvulsant/seizure)
1 po daily x 2 weeks then 2 po daily.
SE: Vertigo, irregular eye movements, nausea, vomiting, blurred or double vision, drowsiness and depression.

Neurontin (gabapentin) 300mg: (antiseizure/neuropathic pain)
1 daily for 3-5 days, 1 twice daily for 3-5 days, 1 three times daily (continue to titrate to 600mg tid.
SE: Drowsiness, dizziness, loss of coordination, tiredness, blurred/double vision, unusual eye movements, or shaking (tremor)

Percocet (oxycodone and acetaminophen) pain 5/325mg *controlled (pain)
1 – 2 po q4-6 hrs prn for pain
SE: Dizziness, drowsiness, mood swings, nausea, vomiting stomach pain, constipation, headache.

Remeron (mirtazapine)15mg (antidepressant)
Take 1 daily at bedtime
SE: Dizziness, drowsiness, lightheadedness, increased appetite, weight gain, dry mouth, or constipation.

Requip (ropinirole) 0.25mg (script #45/1mg #60) (RLS)
Day 1-2 take one 0.25mg tablet each evening.
Day 3-7 take two 0.25mg tablet each evening.
Day 8-14 take two 0.25mg at dinner time and qhs
Day 15 and thereafter: take 1mg at dinnertime and qhs
SE: Nausea, vomiting, constipation, dizziness, drowsiness, weakness, unusual sweating, headache, and dry mouth may occur. If these effects persist or worsen, notify your doctor promptly. You may also develop a sudden drop in blood pressure, which can cause dizziness, nausea, and fainting.

Ritalin (methylphenidate) 10mg (stimulant/ADD, MS fatigue)
1 po bid
SE: Nervousness, trouble sleeping, loss of appetite, weight loss, dizziness, nausea, vomiting, or headache.

Soma (carisoprodol) 250 or 350mg (muscle relaxant)
1 po q6-8hrs prn spasms
SE: Agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea.

Tylenol #3 *controlled (pain)
1-2 q6hrs prn pain
SE: Nausea, vomiting, constipation, lightheadedness, dizziness, or drowsiness.

Ultram (tramadol) 50mg (pain)
1 q4-6 hours max 3/day for breakthrough back pain
SE: Dizziness, drowsiness, nausea, constipation, feeling flushed, headache.

Valium (diazepam) 10mg (benzodiazepine)
Take q 8 hrs prn (or one dose prior to MRI)
SE: Muscle weakness, indigestion, drowsiness, dizziness, slurred speech, confusion.

Vicodin (acetaminophen/hydrocodone) 5/500mg *controlled (pain)
PO qd prn for acute pain
SE: Drowsiness, dizziness, SOB, nausea, vomiting, headache, mood changes, dry mouth.

Xanax (alprazolam) 0.25mg *controlled (antipsychotic)
1 PO q8 hours
SE: Drowsiness, tiredness, dizziness, sleep problems, poor balance, slurred speech, trouble concentrating.

Zofran (odanestron) 8mg (5-HT3 antagonist, nausea/vomiting)
1 po q8hrs prn
SE: Headache, drowsiness, constipation and the chills.