45-year-old female with a history of rheumatoid arthritis currently treated with methotrexate presents with complaints of episodic vertigo,

    April 21, 2024

45-year-old female with a history of rheumatoid arthritis currently treated with methotrexate presents with complaints of episodic vertigo, tinnitus and hearing loss for the past few months. Dix Hallpike maneuver is negative. You suspect that she has Meniere’s disease, and this is later confirmed by additional audiometric testing. You initially offer a prescription for meclizine 50 mg po tid however she tells you that she “had a really bad allergic reaction to meclizine” when she was in college. She cannot articulate the reaction any further. You know that which of the following medications would be an appropriate alternative to meclizine in the episodic management of vertigo associated with Meniere’s disease? SELECT ALL THAT APPLY Question 28Select all that apply: a. Diazepam 1 mg po bid b. Diphenhydramine 50 mg po q6h c. Dimenhydrinate 50 mg po q6h d. Metoclopramide 10 mg po q6h e. Prochlorperazine 10 mg po q6h

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