Module 5 unit C

Question 1

Ergot alkaloids

Answer 1

Dihydroergotamine

Ergotamine

Question 2

MOA of ergotamine

Answer 2

Alters transmission at serotonergic, dopaminergic & a-adrenergic junctions. Vasconstrictor

Question 3

Ergot alkaloid indications

dihydroergotamine, ergotamine

Answer 3

Acute treatment of migraines

Question 4

Triptan

Answer 4

Sumatriptan (Imitrex)

Question 5

Indications of Triptans

Answer 5

Acute abortive treatment of migraines

Question 6

MOA of triptans

Answer 6

Selective activation of 5HT receptors-suppresses the release of CGRP

Question 7

BBW for Ergot alkaloids

Answer 7

Potent inhibitors of CYP34A. Risk of vasospasm.

Question 8

Are ergot alkaloids okay for pregnancy?

Answer 8

No - contraindicated

Question 9

Abortive migraine treatments

Answer 9

Triptans
Ergot alkaloids
Ditan
Oral CGRP receptor antagonist (Ubrelvy)
Analgesics (opioids, NSAIDs, APAP)

Question 10

Ergot alkaloids contraindications

Answer 10

pregnancy (can cause contractions & abortion)
Do not use with triptans
Do not use in renal or liver impairment, CAD, PVD, and uncontrolled HTN

Question 11

Oral CGRP receptor antagonist (acute treatment for HDA)

Answer 11

Ditan (Reyvow)

Question 12

MOA of Ditan (Reyvow)

Answer 12

Activates 5HT1F receptor agonist - inhibits the release of neuropeptides, neurotransmitters, and inhibits the pain pathway.

Question 13

Ditan safety

Answer 13

Schedule V controlled substance, CNS depression

Question 14

preventive (prophylactic) treatment for migraine headaches

Answer 14

Beta Blockers
TCAs
AEDs (Depakote)
Botox
CGRP monoclonal antibodies

Question 15

Treatment for migraine headaches given by injection monthly

Answer 15

CGRP monoclonal antibodies

Erenumab (Aimovig)

Question 16

MOA of Botox

Answer 16

Prevents release of acetylcholine at neuromuscular junctions

Question 17

MOA of Depakote

Answer 17

May augment inhibitory effects of GABA

Question 18

Safety with Depakote

Answer 18

Contraindicated in pregnancy

Question 19

BBW with Depakote

Answer 19

Potentially fatal pancreatitis and hepatitis Neural tube defects in developing fetus.

Question 20

Used for acute gout attacks

Answer 20

NSAIDs, Interleukin-1 inhibitors, glucocorticoids, colchicine

Question 21

used for prevention of gout

Answer 21

colchicine
urate-lowering therapy
xanthine oxidase inhibitors (allopurinol), uricosuric agent (probenecid),
recombinant uric acid oxidase (pegloticase)

Question 22

Three FDA approved drugs for fibromyalgia

Answer 22

Milnacipran
Duloxetine
pregabalin

Question 23

SNRIs for fibromyalgia

Answer 23

Milnacipran (Savella)

Duloxetine (cymbalta)

Question 24

MOA for duloxetine and milnacipran

Answer 24

Boost serotonin and norepinephrine

Question 25

Anticonvulsants for fibromyalgia

Answer 25

pregabalin (Lyrica) - grade A

Gabapentin - Grade B

Question 26

Can cause rhabdomyolysis, especially if the patient is on a statin

Answer 26

colchicine

Question 27

Helps degrade tophi in gout

Inhibits enzyme required for uric acid formation (xanthine)

Answer 27

allopurinol

Question 28

Lowers plasma urate levels by increasing iexcretion of uric acid

Answer 28

probenecid

Question 29

risk of renal stones

Answer 29

probenecid

Question 30

Warning for pegloticase

Answer 30

Do not give to patients with G6PD deficiency - can cause hemolysis and methemoglobinemia

Question 31

problem with muscle relaxants

Answer 31

Cause CNS sedation

Increase risk of falls and injury