Migraine & Malaria

Question 1

Sumatriptan (Imitrex) MOA (2)

Answer 1

5-HT agonist on small peripheral nerves, suppresses release of sensory neuropeptides
less vasoconstricting than ergotamine

Question 2

toxicities related to vasospasm (many)

Answer 2

coronary artery vasospasm, arrhythmias, angina, MI, stroke, seizures, bowel ischemia, dizziness, weakness, myalgia

Question 3

triptan contraindications (many)

Answer 3

breast feeding, heart disease, CVD, CAD, DM, HTN, PVD, pregnancy, renal impairment, seizures, smoking

Question 4

Ergotamine MOA

Answer 4

acts on 5-HT receptors, less specific than Imitrex

Question 5

Ergotamine SE (4)

Answer 5

GI
CV toxicity
hallucinations
neuropathies

Question 6

IV migraine drug?

Answer 6

Dihydroergotamine (Migranel)

Question 7

migraine prophylaxis (9)

Answer 7

Propranolol, Verapamil, Amitriptyline, Fluoxetine, Clonidine, Valproic acid, Topiramate, Botox, ARBs

Question 8

drug contraindicated in G6PD

Answer 8

primaquine

Question 9

radical cure for vivax, ovale?

Answer 9

primaquine

Question 10

contraindicated in myasthenia gravis?

Answer 10

quine & quinodine

Question 11

chloroquine SE (4)

Answer 11

retinopathy
ototoxicity
elongated QT
hemolysis in G6PD pts

Question 12

Mefloquine contraindication (3)

Answer 12

hx mental illness
epilepsy
combined w/ quinine

Question 13

Malarone use (3)

Answer 13

active against tissue & erythrocytic forms
active against P. jirovecii
caution in pregnancy

Question 14

iodoquinol use

Answer 14

amebiasis

Question 15

paromycin use?

Answer 15

asymptomatic amebiasis, giardiasis, trich

Question 16

TOC toxoplasmosis?

Answer 16

Pyrimethamine

Question 17

2nd choice tx for P. jirovecii

Answer 17

pentamidine

Question 18

2nd choice for amebiasis, giardia, & trich

Answer 18

tinidazole