IC13 Flashcards
Generic name for LIORESAL
baclofen
Intrathecal administration of LIORESAL cause Baclofen conc in CSF to be ____ times higher compared to oral administration
100 times
Because of slow CSF circulation and a baclofen concentration gradient from the___ to the____ CSF, the PK parameters should be interpreted considering a___
lumbar; cisternal; high inter- and intra-patient variability
How is intrathecal baclofen cleared?
via bulk-flow removal of CSF
LIORESAL: Direct infusion into the spinal subarachnoid space bypasses absorption processes and allows exposure to the _____.
receptor sites in the dorsal horn of the spinal cord
LIORESAL: indication
- Management of severe spasticity due to spinal cord injury or multiple sclerosis who are unresponsive to oral baclofen or who experience unacceptable side effects at effective oral doses.
- alternative to destructive neurosurgical procedures.
LIORESAL: can it be administered via parenteral routes e.g. IV,IM other than intrathecal?
No
What device is used to administer LIORESAL?
implantable pump
LIORESAL: adverse effects
life-threatening CNS depression, cardiovascular collapse and/or respiratory failure
What can be observed at the tip of implanted catheter with LIORESAL* Intrathecal? What are the consequences?
Inflammatory mass; decreased therapeutic response, pain and serious neurological impairment
Early symptoms of baclofen withdrawal may include ____
return of baseline spasticity, pruritus, hypotension, and paresthesias
Advanced LIORESAL* Intrathecal withdrawal syndrome may resemble _____
autonomic dysreflexia, infection (sepsis), malignant hyperthermia, neuroleptic-malignant syndrome, or other conditions associated with a hypermetabolic state or widespread rhabdomyolysis.
Caution use of LIORESAL* Intrathecal in patients with renal impairment because baclofen is _____.
primarily excreted unchanged through the kidneys
LIORESAL: storage
Protect from heat (store at 15-30°C). Do not freeze. Do not heat sterilize.
LIORESAL: Each ampoule is intended for___ use only.
single
If LIORESAL is to be diluted, what diuent to use?
sterile preservative-free sodium chloride injection (under aseptic condition)
Can dextrose be mixed with LIORESAL?
No, incompatible
Can LIORESAL be mixed with other infusion or injection solutions?
No
LIORESAL: very common side effects
Drowsiness, muscle weakness
PRIALT: Generic name
ziconotide
MOA for PRIALT
Blocks N-type calcium channel located on the primary nociceptive (A-δ and C) afferent nerves in the superficial layers (Rexed laminae I and II) of the dorsal horn in the spinal cord
Indication for PRIALT
management of severe chronic pain (if pt is intolerant or refractory to other tx)
Can PRIALT be administered IV?
No
PRIALT: Saline solutions containing___ are NOT appropriate for intrathecal drug administration and should not be used due to risk of _____.
preservatives; neurotoxicity
