Neuro Flashcards
What is St John’s wort and what is it used for?
St Johns Wort is a herbal medicine used to treat the symptoms of mild and moderate depression
Why is it important to know that a patient is taking a complementary therapy like St Johns?
(1. ) It is important to know that a patient is taking a complementary medicine as it may interact with other prescribed medications
(2. ) for example St Johns wort interacts with SSRI antidepressants, the oral contraceptive pill, warfarin, cyclosporin, HIV medication, digoxin, statins and many others.
In a patient with a new diagnosis of moderate depression what class of drug would initially be used? Name 3 examples of this group
(1. ) DX of moderate depression would usually be prescribed a SSRI
(2. ) Sertraline, citalopram, fluoxetine
What is first and second line management of migraine related headache?
(1. ) 1st line = Simple analgesia, especially NSAIDs, aspirin and paracetamol.
(2. ) 2nd line = Triptans (Serotonin 5-HT)
Triptans: how do they exert their action?
(1. ) Triptans are selective agonists of 5-HT receptors.
(2. ) Stimulation of 5-HT1B receptors on smooth muscle cells of blood vessels leads to intracranial vasoconstriction.
(3. ) There is also thought to be some action on 5-HT1D receptors which blocks the release of vasoactive peptides from trigeminal neurons and neurotransmitters in the dorsal horn.
Anti-emetics (metoclopramide, prochlorperazine) manage sickness in migraine. How do they act?
(1. ) Metoclopramide and prochlorperazine are dopamine receptor antagonists.
(2. ) Nausea and vomiting is coordinated by the vomiting centre within the medulla.
(3. ) This area is rich in dopamine receptors and antagonism of these can reduce the nausea associated with migraine.
Prophylaxis of migraines?
(1. ) For patients with frequent attacks prophylaxis is usually initiated
(2. ) Propranolol (a Beta-blocker), Topiramate (anti-epileptic) or Amitriptilline (Tricyclic antidepressant)
