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39 Cards in this Set
- Front
- Back
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The following SE are seen with which anti epileptic?
rash, syndrome of inappropriate antidiuretic hormone release, aplastic anemia, thrombocytopenia, anemia, leucopenia |
Carbamazapine
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Testing for HLA B-1502 is recommended for Asians prior to initiating which antiepileptic therapy?
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Carbamazepine
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Which medication is used only for absence seizures
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Ethosuximide
(Valproic acid is also a first line agent) |
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T or F
Unlike Phenytoin, fosphenytoin displays linear kinetics |
False
Fosphenytoin is a prodrug for phenytoin Used in status epilepticus Advantages over phenytoin (a) Intramuscular or intravenous dosing (b) Phlebitis is minimized. (c) Infusion can be up to 150 mg of phenytoin equivalents per minute. (d) Can deliver in normal saline solution or D5W |
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__________ decreases lamotrigine metabolism
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Valproic Acid
this interaction requires even slower titration and lower final doses. (Ex. 25mg QOD) |
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What AE do you have to worry abt with Lamotrigine?
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RASH
lamotrigine must be titrated slowly to avoid a rash. |
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T or F
Like Carbazapine, Oxcarbazepine is an autoinducer |
False
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T or F
25%–30% of patients with hypersensitivity to carbamazepine will have hypersensitivity to oxcarbazepine |
True
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T or F
hyponatremia more common than with carbamazepine |
True
increased dose and increased age increase risk of hyponatremia |
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Name the drug with the Following AE profile:
Dose-related adverse effects: nystagmus, ataxia, drowsiness, cognitive impairment Non–dose-related adverse effects: gingival hyperplasia, hirsutism, acne, rash, hepatotoxicity, coarsening of facial features |
Phenytoin
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FDA indication only for Lennox-Gastaut syndrome
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Rufinamide
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Why is Lorazepam used more frequently in status epilepticus compared to Diazepam?
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Lorazepam less lipophilic (drug wont concentrate in fatty areas where it doesnt need to be)
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Tor F
AVOID VALPROIC ACID DURING PREGNANCY! |
TRUE
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If an anti epileptic drug is discontinued, it is usually tapered for several _______
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Months
a typical regimen would reduce the dose by one-third for 1 month, reduce it by another one-third for 1 month, and then discontinue it. |
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T or F
All antiepileptic medications may contribute to osteopenia or osteoporosis. |
True
the medications most often associated with poor bone health are carbamazepine, clonazepam, phenobarbital, and valproic acid |
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Oligohydrosis, Renal stones, and word-finding difficulties are all SE of which anti epileptic medication
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Topirimate
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T or F
If the patient has an additional stroke while taking aspirin, increasing the aspirin dose to provide additional benefit. |
If the patient has an additional stroke while taking aspirin, there is no evidence that
increasing the aspirin dose will provide additional benefit. |
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T or F
High-protein diets decrease absorption of carbidopa-levodopa |
T
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What are the long term effects of Carbidopa-levodopa?
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wearing-off and on-off phenomena, involuntary
movements (dyskinesias) |
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How do you treat the "wearing off" AE of carbidopa-levodopa?
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adding dopamine agonist, adding COMT inhibitor, or increasing frequency/dose of levodopa.
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How do you treat the on-off phenomena of carbidopa-levadopa?
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adding entacapone, rasagiline, pramipexole, ropinirole, apomorphine, and selegiline or redistributing dietary protein.
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How do you treat dyskinesia AE of carbidopa-levodopa?
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decreasing the levodopa dose and adding amantadine as an antidyskinetic drug.
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Name 3 Direct dopamine agonists
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bromocriptine, pramipexole, ropinirole
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These Dopamine agonists also have FDA indications for restless legs syndrome
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Pramipexole and ropinirole
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____________is indicated for acute, intermittent treatment of “off” episodes associated with advanced Parkinson disease
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Apomorphine: short-acting dopamine receptor agonist
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name two anticholinergics useful for tremor in Parkinsons patients
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trihexyphenidyl, benztropine
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_______ is used as add on therapy to reduce dyskinesias in Parkinsons patients with long term use of carbidopa-levodopa
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Amantadine
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What is the most unique AE of Amantadine?
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Livido Reticularis
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______Prevent breakdown of dopamine, more levodopa available to cross blood-brain
barrier |
COMT inhibitors
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T or F
Avoid typical antipsychotics, risperidone, and olanzapine because they may worsen Parkinson symptoms. |
True
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Which two triptans have non oral administration routes?
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Sumatriptan and zolmitriptan have nonoral administration routes (subcutaneous [sumatriptan] and intranasal [sumatriptan and zolmitriptan])
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Triptans are Contraindicated within 2 weeks of ________; do not use within 24 hours of _________
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MAOIs
Ergotamines |
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This opioid has a nonoral administration route (intranasal) that should be considered for patients with Migraines and nausea/vomiting.
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Butorphanol
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Prophylaxis for tension headaches
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Tricyclic antidepressants or Botulinum toxin
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Prophylaxis for cluster HA
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Verapamil
Melatonin Suboccipital injection of betamethasone Lithium |
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If a headache goes away after Oxygen therapy, it is most likely a _____ headache
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Cluster
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Acute relapses of MS are treated with _____________
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corticosteroids
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T or False
Do not take apomorphine if you are allergic to sulfa |
TRUE
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What are medication options for patients with migraines and cardiac disease ?
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All triptans and ergotamines are contraindicated in this situation.
Possible choices are Midrin or NSAIDS |
