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THERA II > Neurology > Flashcards

Neurology Flashcards

1
Q

What is considered a medication overuse headache?

A

Opioid/triptan/ergot use 10 days or more, OTC analgesic or anti-inflammatory use of 15 days or more

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2
Q

Which triptan is considered to be safe during pregnancy? (although still not preferred)

A

Sumatriptan

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3
Q

Out of these anti-epileptics: valproic acid, carbamazepine, phenytoin & topiramate… which has potential to cause cognitive impairment?

A

Topiramate

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4
Q

Which of the following is an amphetamine? (Ritalin, concerta, dexedrine, wellbutrin)?

A

Dexedrine

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5
Q

What deficiency is common in those with restless leg syndrome?

A

Iron deficiency

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6
Q

What are the preferred anti-epileptics during pregnancy?

A

Lamotrigine and levetiracetam

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7
Q

What should childbearing women on anti-epileptics be advised of?

A

To take 1 mg folic acid along with medication

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8
Q

What is first line therapy for Bells Palsy?

A

Corticosteroids (prednisone 60 mg/d PO x5 days, then taper)

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9
Q

When should corticosteroids ideally be initiated by for Bells Palsy?

A

Within 72 hours

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10
Q

What is the tx for children with bells palsy?

A

Treatment not recommended, usually full recovery occurs in children w/o therapy

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11
Q

What are some non-pharmacological options for seizures?

A

Avoiding triggers, ketogenic diet, mindfulness

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12
Q

What anti-seizure medication is known to be tetarogenic?

A

Valproic acid

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13
Q

What is first line tx for BPPV?

A

Epley maneuver

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14
Q

What are some vestibular suppressants?

A

Dimenhydrinate (Gravol) and scopolamine patches

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15
Q

What is typical tx for Meneire’s disease?

A

Vestibular suppressants and anti-emetics as needed, salt restriction, avoid caffeine/nicotine, vestibular rehab therapy

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16
Q

What medications have potential to cause drug-induced vertigo?

A

ACEi/beta blockers/diuretics, benzos/opioids/antidepressants, carbamazepine/oxcarbazepine/levetiracetam, aminoglycosides/fluoroquinolones, digoxin/nitrates/sidenafil

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17
Q

What is the recommended therapeutic approach for ADHD?

A

Multimodal: psychoeducation, psychosocial and pharmacological therapy

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18
Q

What is true for ADHD medications and children?

A

All medications considered off-label for children <6 years

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19
Q

What is first line therapy for ADHD in children 6-17 years of age?

A

Stimulants: methylphenidate (may be better tolerated) or amphetamine

20
Q

What is first line therapy for adults with ADHD?

A

Stimulants: amphetamines (preferred) or methylphenidate

21
Q

What are some brand names of methylphenidate stimulant medications for ADHD?

A

Ritalin, biphentin, concerta, foquest

22
Q

What are some brand names of amphetamine stimulants for ADHD?

A

Adderall, dexedrine, vyvanse

23
Q

What are some adverse effects of stimulants?

A

Headache, dry mouth, insomnia, GI upset, blurred vision, dizziness, decreases appetite, increased HR/BP. May uncover/worsen tics

24
Q

What are contraindications of stimulants?

A

Symptomatic cardiovascular disorders, moderate-severe hypertension, narrow angle glaucoma, untreated hyperthyroidism, hx of mania/psychosis

25
Which 2nd line non-stimulant for ADHD is not recommended for adults?
Guanfacine XR
26
What monitoring is required for those started on stimulants?
BP/HR and ECG if any hx CVD, height/weight,
27
What is the general pharmacological approach for acute migraines?
Triptans +/- NSAID +/- anti-emetic
28
Which medication is considered first line for moderate-severe migraines?
Triptans
29
What medication is 2nd line for migraines and why?
Ergots (ex: dihydroergotamine) d/t decreased efficacy and increased nausea compared to triptans
30
What are some adverse effects of triptans?
Nausea, facial flushing, tingling, paresthesia, fatigue, somnolence, chest discomfort/tightness/palpitations, serotonin syndrome (rare)
31
When should triptans be taken?
Should be taken ASAP, 30 minutes after initial trigger or mild symptoms
32
When should maintenance/ prophylaxis therapy be offered for migraines?
If more than 3-6 headache days in a month, if experiencing medication overuse headache, if migraines decreasing QOL or attacks fail to respond to acute tx
33
What triptans are considered safe for children experiencing migraines?
Almotriptan (12 years or older), rizatriptan (6 years or older)
34
What is first line for migraine maintenance therapy?
Beta-blocker, amitriptyline, topiramate, or candesartan (least preferred)
35
What is recommended with migraine prophylaxis in terms of dose and titration?
Start with monotherapy at low dose and titrate up every 1-2 weeks. Typically takes 1-2 months to see benefits, ensure an adequate trial
36
What medication may be effective for sundowning in dementia?
Trazadone 12.5/25/50 mg PO HS
37
What is the recommended approach for psychosis/agitation in dementia?
Non-pharm first, can use SHORT term antipsychotics (risperidone, quetiapine, olanzepine, haloperidol)
38
What is the pharmacologic approach for chronic neuropathic pain?
TCAs, gabapentinoids, SNRIs
39
What is the tx for trigeminal neuralgia?
Carbamazpeine
40
What class of medications can be useful for intermittent restless leg syndrome symptoms?
Levodopa preparations
41
What is the preferred class of medications for daily, persistent restless leg symptoms?
Dopamine agonists or GABA derivatives
42
What is first line tx for the motor symptoms of Parkinsons?
Levodopa IR
43
What is one thing to educate clients on who take levodopa IR?
Avoid protein d/t chance of absorption being decreased
44
What are some potential adverse effects of levodopa IR?
N/V, anorexia, headache/confusion/dizziness/hallucination, nightmares, insomnia, depression, rash, discoloured urine and darkened sweat, increased libido, dyskinesia
45
What other class of medication can be considered for Parkinson's in those less than 60 years of age?
Can consider dopamine agonists (DA) to delay levodopa, usually prescribed initially in this age group. Cannot prescribe if >70 years, cognitive impairment, or excessive daytime sleepiness/hallucinations
46

THERA II (7 decks)

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