Question 27

Therapeutic duplication may be a concern for a patient prescribed both trazodone and Nortriptyline.

Therapeutic duplication occurs when a patient is prescribed multiple medications that serve the same therapeutic purpose. In this case, both trazodone and nortriptyline are antidepressants, which raises concerns about increased side effects and the potential for overdose.

A) Nabumetone

Nabumetone is a nonsteroidal anti-inflammatory drug (NSAID) used primarily for pain relief and inflammation. It does not share the same therapeutic effects as trazodone, which is an antidepressant, making it an unlikely candidate for therapeutic duplication in this context.

B) Nystatin

Nystatin is an antifungal medication used to treat fungal infections. It does not have any overlapping therapeutic indications with trazodone, meaning it does not pose a risk for therapeutic duplication.

C) Nortriptyline

Nortriptyline is another antidepressant that can be used to treat depression and chronic pain conditions. When prescribed alongside trazodone, it creates a situation of therapeutic duplication, which can lead to heightened risk of side effects, such as sedation and cardiovascular effects.

D) Nicardipine

Nicardipine is a calcium channel blocker used primarily for hypertension and angina. It does not have the same therapeutic purpose as trazodone and therefore does not present a risk for therapeutic duplication in this scenario.

Conclusion

Nortriptyline is the correct answer as it is another antidepressant, and its use alongside trazodone constitutes therapeutic duplication, which can increase the risk of side effects. In contrast, nabumetone, nystatin, and nicardipine do not overlap in therapeutic indications with trazodone, thereby mitigating concerns about duplication. Recognizing the potential for therapeutic duplication is crucial for patient safety and effective medication management.