Pharm - Exam 1 Flashcards
- What is the med that is indicated for the absence seizures only?
Ethosuximide
- Which drug has a side effect of weight loss?
Felbamate
Also : Ethosuximide, Topiramate, Zonisumide
- What drug does not cause diplopia?
Zonsiumide
Lacosamide, Lamotrigine, Phenytoin, Pregabalin, Tiagabine, Vigabatrin
- What are 2 drugs that are pan CYP inducers?
Phenobarb and CBZ
- What was false regarding gabapentin?
Not a pan inducer of hepatic enzymes
a. it is needed in high dose, is excreted unchanged, and has no known DIs
- How much active drug in phenytoin sodium?
0.92
- Calculate the loading dose
DL = (Vd)(Css)/(S)(F)
Vd = .65 x Wgt (Kg)
Css = 18!!!!
S (Sodium) Capsule & Injec = .92
S (Acid) Tablet & suspension = 1.0
F = 1
- Calculate the loading dose
(convert pounds to kg)
- What is the VPA dose range?
50-150
- What drug do you have to serum monitor?
Phenytoin (Also CBZ & VPA)
- What drug causes gingival hyperplasia?
Phenytoin
- What are the symptoms of acute intoxication of phenobarbitol?
Slurred speech,
Nystagmus,
Ataxia (unsteady gate)
- What is converted to phenobarb via hepatic oxidation?
Primidone
- What has to be tapered slowly to prevent rebound convulsions?
Phenobarb
Also Delirium
- Why do you have to start topirimate slowly?
Cognitive impairment
Used for migraines
- What’s not first line for early established stat epi?`
IV Valproate
- If you are on valproic acid and want to start lamotrigine why slowly?
SJS
Decrease Lamotragine by 50% if used in combo w/ VPA
- Typical first line for Parkinsons?
Rasagiline
- What is true about Diastat?
all of the above
- Used for breakthrough seizures,
- When on established AED,
- Gel formulation w/ rectal admin,
- Can’t give more than 5x a month
- Which of the following drugs has significant drug interaction?
Valproic acid
NOT
Gabapentin
Levitiracetem
Pregabalin
- Which drugs are used for general anesthesia in the treatment of stat epi?
Midazolam & Propofol
- What is true?
All of the above
- Lamotrigine level is inc during the placebo week,
- CBZ interferes w estrogen and makes OCP ineffective,
- Lamotrigine decreases the bioavailability of progesterone & makes OCP ineffective
- What is true about Capylidene in the tx of Alzheimer’s?
Not 1st line
- It is a medical food
- Watch for risk of ketoacidosis
- Increases triglyceride levels
- Pt with a h/o Alzheimer’s now has aggression w no other Sx?
Anticonvulsants
- Pt dx w new Alzheimer’s w h/o IBS, what should the initia tx be?
Donepezil
- What drug causes memory loss?
NSAIDs
- MOA of donepezil?
Ach inhibitor only
- What cholinesterase inhibitor comes in a patch?
Rivastigmine
- After 6 months what would the pts MMSE score would be if they started at 23?
24 (Inc 1-1.5)
- Why do you use aspirin in the tx of AD?
Improve perfusion & helps w vascular dz
- Alzheimer’s is now moderate, was on low dose donepezil, how should tx change?
Memantine
Donepezil in high doses can be used for moderate to severe but the dose is 23 mg – question option suggested increases
- MOA of memantine?
NMDA antagonist
- Young Parkinson’s patient preventing w/ tremors, what should initial tx be?
Amantadine
- What do you add to CD/LD to extend?
COMT inhibitor (Entecapone)
- 70 yo w/ not otherwise specified Parkinson’s?
CD/LD
- Delayed on/no-on?
Add apomorphine plus trimethomenzamine
- Clinical predictor of disease in PD?
Decrease response to dopamine
- Who will most benefit from starting CD/LD initially?
Older pt w/ cog and functional impairment
- What is the rationale for using Selegeline in tx of PD?
Delay need for LD by 9 months
- ADR of amantadine?
Tachyphylaxis in 1- 2 months
- MOA of Rotigotine?
Dopamine antagonist
- Which of the dopamine agonists need to be renally dose adjusted?
Pramipexole
- What class has the ADR brown-orange urine?
COMT inhibitor
- What are the side effects of Galantamine?
N/V/D
- What drugs don’t you give to pregnant people?
all of the above
Phenytoin, Valproic acid, Phenobarb
