week 1 flashcards

Card Set Information

Author:
tallone4830
ID:
283724
Filename:
week 1 flashcards
Updated:
2014-09-24 13:04:19
Tags:
week flashcards
Folders:

Description:
week 1 flashcards
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user tallone4830 on FreezingBlue Flashcards. What would you like to do?


  1. triptans mechanism of action
    agonist at 5HT-1B and 5HT-1D receptors, result in vasoconstriciton. presynaptically, agonism at these receptors. also inhibits the release of neurotransmitters that activate pain fibers.
  2. triptans pharmacokinetics
    sumatriptan fastest, reaches peak plasma concentrations 12 min p SC. frovatriptan/naratriptan longest acting (slowest onset). sumatriptan/zolmitriptan also available as nasal sprays (nausea/vomiting).
  3. triptams metabolism
    metabolism often by MAO-A (frovatriptan CYP1A2, eletriptan CYP3A4 / PGP).
  4. triptans contraindications
    CAD, uncontrolled HTN, MAOI use within 14 days.
  5. triptans interactions
    triptan + triptan (additive). triptan + ergot w/i 24h. triptan + MAOI w/i 14d. rizatriptan + propranolol (reduce dose).
  6. triptans indications
    migraines (abortive), cluster headaches (abortive). longer-acting formulations may be used for prevention of menstrual migraines.
  7. triptans side effects
    paresthesias, chest/jaw/neck tightness/pain/pressure, hypertension.
  8. triptans dosing
    can typically repeat dose, but there is a max dose per 24 hours. adjust doses in hepatic impariment (metabolized by liver). if one triptan doesn't work, try another.
  9. Axert
    almotriptan (triptan)
  10. Relpax
    eletriptan (triptan)
  11. Frova
    frovatriptan (triptan)
  12. Amerge
    naratriptan (triptan)
  13. Maxalt
    rizatriptan (triptan)
  14. Imitrex
    sumatriptan (triptan)
  15. Zomig
    zolmitriptan (triptan)
  16. OTC migraine combos
    1. drug that increases GABA activity, 2. drug that vasoconstricts, 3. drug that is a CNS depressor
  17. Topamax
    topiramate (AED - miscellaneous)
  18. topiramate mechanism of action
    unknown, likely has multiple mechanisms including Na or Ca channel blocking, GABA potentiation, NMDA antagonism, or inhibition of carbonic anhydrase.
  19. topiramate indications
    migraines (prophylaxis), seizure disorders (broad-spectrum)
  20. topiramate dosing
    TAPER UP, TAPER DOWN. will require dosing adjustments in hepatic/renal disease.
  21. topiramate side effects
    significant cognitive impairment, fatigue, paresthesias, taste changes, weight loss.
  22. topiramate monitoring
    do NOT need to monitor levels (newer AED)
  23. topiramate contraindications
    pregnancy (cat D, cleft palate in 1st trimester)
  24. topiramate interactions
    topiramate + OCPs (decreased levels of OCP), topiramate + other AEDs (multiple interactions due to induction/inhibition of hepatic enzymes)
  25. Dilantin
    phenytoin (AED - hydantoin)
  26. phenytoin indications
    seizure disorders (broad-spectrum but not absence seizures), status epilepticus (2nd line)
  27. phenytoin mechanism of action
    sodium channel inhibitor, slows their recovery from an inactivated state (preventing repetitive firing). selectively targets channels that are opening/closing rapidly. (may also be other mechanisms)
  28. phenytoin pharmacokinetics
    exhibits saturation kinetics: at low concentrations first order kinetics, at high concentrations zero order kineti H highly protein bound.
  29. phenytoin dosing
    TAPER UP, TAPER DOWN. ER formulations contain 8% less drug than IR (monitor closely when switching).
  30. phenytoin interactions
    phenytoin + OCPs (decreased levels of OCP), phenytoin + other AEDs (multiple interactions due to induction/inhibition of hepatic enzymes). may also saturate pathways used by other drugs.
  31. phenytoin monitoring
    DO need to monitor levels (older AED)
  32. phenytoin contraindications
    pregnancy (cat D, fetal hydantoin syndrome), bradycardias/certain arrhythmias
  33. phenytoin side effects
    BBW for cardiovascular risk with rapid infusion. gingival hyperplasia (regular dental exams), coarsening of facial features in women. lateral gaze nystagmus.
  34. fosphenytoin
    prodrug, dosed in phenytoin equivalents (PE) to avoid need for conversion. it is better tolerated, safer, and leads to quicker therapeutic levels but is more expensive.
  35. Lamictal
    lamotrigine (AED - phenyltriazine)
  36. lamotrigine mechanism of action
    sodium channel inhibitor, slows their recovery from an inactivated state (preventing repetitive firing). may also inhibit Ca channels and glutamate release.
  37. lamotrigine indications
    seizure disorders (broad-spectrum), bipolar disorder
  38. lamotrigine pharmacokinetics
    only available orally (but has multiple oral forms). can produce auto-induction at higher doses.
  39. lamotrigine monitoring
    do NOT need to monitor levels (newer AED)
  40. lamotrigine SE
    BBW for serious rash (SJS). discontinue at first sign of unexplainable rash.
  41. lamotrigine interactions
    lamotrigine + OCPs (decrease levels of lamotrigine). lamotrigine + other AEDs (multiple interactions due to induction/inhibition of hepatic enzymes)
  42. lamotrigine contraindications
    okay-ish in pregnancy (cat C)
  43. lamotrigine dosing
    TAPER UP, TAPER DOWN. will require dosing adjustments in hepatic/renal disease. phenytoin, carbamazepine, and phenobarb reduce lamotrigine levels; valproate increases levels.

What would you like to do?

Home > Flashcards > Print Preview