Gabapentanoids

Question 1

Indicated use of gabapentanoids

Answer 1

Neuropathic pain
And
Focal seizures with or without secondary generalisation

Question 2

Elimination of both drugs?

Answer 2

PREgablin = 98% excretes in urine unchanged
GABApentin = excreted unchanged (not metabolised)

Question 3

Who is at greater risk of gabapentiniod misuse?

Answer 3

People with history or drug and alcohol use disorder
Or if used
Via non oral routes = nasal insufflation, iv injection

Question 4

Features of an overdose of gabapentanoids

Answer 4

Dizziness
Ataxia
Confusion
Slurred speech
Myoclonic jerks
Seizures
Renamly cleared therefore toxicity to kidneys

Question 5

Treatment for p
POSIONINg

Answer 5

Airway = intubated and ventilate
Circulation of IV FLUID = to resuscitate
Decontamination = activated charcoal (must be present within 2 hours after time of ingested

Question 6

Why dose pregablin have a higher misuse then GABApentin?

Answer 6

1. GABApentin has saturate absorption
2. PREgablin more rapidly absorbed
3. PREgablin has increased binding to voltage gated calcium channels

Question 7

Pregablin PK

Answer 7

1. 98% excreted in urine unchanged
   = dose adjustment needed in renal impairment
2. Crosses BBB = not bound to plasma proteins

Question 8

Gabapentin
PK

Answer 8

1. Saturable absorption (increasing dose = decreasing bioavailabilty)
2. Mostly unbound to plasma proteins
3. Excreted in urine unchanged (no metabolites

Question 9

Why does Pregablin have a higher misuse potential

Answer 9

1. Gabapentin has a saturable absorption
2. Pregablin is more readily absorbed
3. Pregablin has increased bidning to voltage gated calcium channels