HA- AEDs DI

Question 1

ADEs used in migranes

Answer 1

Topiramate, VPA

Question 2

ADEs indication in migraine

Answer 2

Preventative treatment

Question 3

MoA of topiramate

Answer 3

Blocks voltage-dependent sodium channels

Enhances GABAa activity

Antagonizes AMPA/kainate glutamate receptors

Weakly inhibits carbonic anhydrase

Question 4

Topiramate ADEs

Answer 4

Cognitive dysfunction, CNS effects, nephrolithiasis, metabolic acidosis, angle-closure glaucoma, oligohidrosis/hyperthermia, suicidal ideation, weight loss, paresthesia

Question 5

Topiramate should be avoided in what special population?

Answer 5

PREGNANCY

Question 6

Topiramate counseling point

Answer 6

Counsel on hydration

Question 7

Time for topiramate trial

Answer 7

2-3 months

Question 8

VPA MoA

Answer 8

Increases GABA or may enhances the action of GABA

Blocks voltage-dependent sodium channels

Question 9

VPA ADEs

Answer 9

CNS effects, hematologic effects, hepatotoxicity, encephalopathy, TEN, SJS, DRESS, pancreatitis, suicidal ideation

Question 10

VPA CIs

Answer 10

Prevention of migraine in pregnancy women of childbearing potential who aren’t using effective contraception

Also CI’ed in severe hepatic impairment and mitochondrial DNA polymerase gamma mutation-associated mitochondrial disorders