CNS Drugs II

Question 1

During a medical emergency of status epilepticus, what two IV meds should you give?

Answer 1

diazepam, phenytoin (or fosphenytoin)

Question 2

What are the 3 anti-seizure strategies?

Answer 2

1. enhance GABA transmitter activity, 2. reduce excitatory influences, 3. modulate ionic conductance

Question 3

This anti-seizure drug stabilizes neuronal membranes and restricts Na and Ca ion flow.

Answer 3

Phenytoin

Question 4

What is a big adverse side effect of phenytoin?

Answer 4

dose altering: nystagmus, ataxia, diplopia, gingival hyperplasia, Fetal hydation syndrome

Question 5

What are the features of fetal hydantoin syndrome?

Answer 5

cleft lip/palate, facial abnorms, heart anomalies, mental retardation

Question 6

This drug is most efficacious for partial seizures, stabilizes neuronal membranes, and has hepatic toxicity along with CYP4 drug interactions.

Answer 6

Carbamazepine

Question 7

This drug is a derivative of carbamazepine with less of the side effects and drug interactions

Answer 7

Oxcarbazepine

Question 8

What drug : 1. raise seizure threshold to avoid febrile seizure. 2. causes babies to sleep. Used as an anticonvalsant, Primadone still used.

Answer 8

Phenobard

Question 9

This is the most teratogenic of the antiseizure drugs

Answer 9

Valproic Acid Derivative

Question 10

What two drugs should be avoided in the 1st trimester of pregnancy?

Answer 10

trimethadione and divalproex

Question 11

T/F, many anticonvulsants do not effect the use of steroid contraceptives

Answer 11

False

Question 12

Abrupt withdrawal of anti-seizure medications may trigger what?

Answer 12

status epilepticus

Question 13

These drugs work well with partial seizures.

Answer 13

GABA modulators

Question 14

This GABA analog can be used for neuropathy and fibromyalgia BUT is a schedule V drug.

Answer 14

Pregabalin (Lyrica)

Question 15

Chronic recurrent headache types?

Answer 15

tension, cluster, migrain

Question 16

Tx for tension headaches

Answer 16

analgesics, anxiolytic/sedatives, muscle relaxers, tricyclic antidepressants

Question 17

Typical pt that would present with cluster headaches?

Answer 17

middle aged male

Question 18

Tx for cluster headaches?

Answer 18

migraine tx + supplemental O2

Question 19

The activation of the trigeminal nucleus in the brainstem involves this?

Answer 19

calcitonin gene-related peptide

Question 20

What drug classes are used to tx migraines?

Answer 20

serotonin agonist, dopamine antagonist

Question 21

What are the two migraine classifications and their frequencies?

Answer 21

episodic (<15) and chronic (>15)

Question 22

Ergot deriative + caffeine migraine medication

Answer 22

Cafergot (oral, rectal)

Question 23

These drugs are 5-hydroxytryptamine receptor agonists used for migraine tx

Answer 23

Triptans

Question 24

Triptans are contraindicated in these pt?

Answer 24

known coronary or PVD

Question 25

Monoclonal antibody inhibiting CGRP receptor to reduce migraine frequency

Answer 25

Erenumab