week .5 flashcards

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week .5 flashcards
2014-09-24 13:03:00
week flashcards

week .5 flashcards
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  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)