SCENARIO 1
What are the errors in the following prescriptions (1 per prescription)? Rewrite
each prescription correctly. What is each medication classification? What is the mechanism
of action (MOA)?
· Ubrelvy 200 mg PO at onset of migraine #30 0 RF
· memantine/donepezil (Sinemet) 7/10 mg po once daily #30 1 RF
· Stalevo 200 mg po TID #90 2 RF
· levothyroxine 137 mg PO daily #30 3 RF
· omeprazole (Protonix) 40 mg PO daily before breakfast #30 3 RF
Answer & Explanation
1. Ubrelvy 200 mg PO at onset of migraine #30 0 RF
Error
The dose is incorrect. Ubrogepant (Ubrelvy) does not have a 200 mg single dose.
Correct Prescription
Ubrogepant 50 mg PO at onset of migraine; may repeat once after 2 hours if needed. Max 200
mg/day. #30, 0 refills
Medication Classification
• CGRP receptor antagonist
• Antimigraine agent
Mechanism of Action (MOA)
Ubrogepant works by blocking calcitonin gene-related peptide (CGRP) receptors, which play a
key role in migraine pathophysiology. CGRP causes vasodilation and pain transmission during
migraine attacks. By inhibiting CGRP binding, ubrogepant reduces neurogenic inflammation and
headache pain without causing vasoconstriction.
, Patient History Considerations
• Appropriate for patients who cannot tolerate triptans or have cardiovascular disease
• Liver impairment requires dose adjustment
• Avoid strong CYP3A4 inhibitors
2. memantine/donepezil (Sinemet) 7/10 mg PO once daily #30 1 RF
Error
The brand name is incorrect. Sinemet is carbidopa/levodopa, not memantine/donepezil.
Correct Prescription
Memantine/donepezil (Namzaric) 7 mg/10 mg PO once daily in the evening #30, 1 refill
Medication Classification
• NMDA receptor antagonist (memantine)
• Acetylcholinesterase inhibitor (donepezil)
• Alzheimer's disease combination therapy
Mechanism of Action (MOA)
• Memantine blocks NMDA glutamate receptors, reducing excitotoxic neuronal damage
• Donepezil inhibits acetylcholinesterase, increasing acetylcholine levels in the brain
Together, they improve cognition and slow symptom progression in moderate-to-severe
Alzheimer's disease.