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Therapeutics > TPX Epilespy & Migraine& Pain > Flashcards

TPX Epilespy & Migraine& Pain Flashcards

1
Q

Focal seizures

A

Treatment of choice:
Levetiracetam
Lamotrigine
Oxcarbazepine

Others:
Carbamazepine
Lacosamide

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2
Q

Carbamazepine

A

Tegretol

Na channel blocker

Enzyme Inducer

Side effects:

Black box warning for rash (HLA Variants)

helps with depression

sedation

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3
Q

Drugs with rash cross sensitivity

A

Lamotrigine
Carbamazepine
Phenytoin
Phenobarbital

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4
Q

Dose reduction with GFR reduction

A

Pregabalin
Gabapentin
Levetiracetam
Oxcarbamazepine

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5
Q

Phenobarbital

A

Luminal
Barbiturate
Prolong GABA openings

sedation

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6
Q

Benzodiazepines

A

Increase frequency of GABA openings

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7
Q

Tiagabine

A

Gabatril

Inhibits GAT-1

causes sedation

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8
Q

Vigabatrin

A
  • Sabril*
    Inhibits GABA-T
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9
Q

Phenytoin

A

Dilantin

Sodium channel blocker
causes sedation

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10
Q

Lamotrigine

A

Sodium channel blocker

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11
Q

Zonisamide

A

Na channel blocker
Calcium channel blocker
CA inhibitor

Weight loss
depression

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12
Q

Lacosamide

A

Vimpat

Slow inactivation of Na channels

Helps depression

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13
Q

Valproate

A

Depakote

GABA enhancement
Na channels
Ca channels

helps w/ depression
weight gain

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14
Q

Gabapentin and pregabalin

A

Ca channels

Weight gain
Renally dosed

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15
Q

Topiramate

A

Na channels
Ca channels
Antagonizes glutamate
CA inhibitor

Weight loss
Depression
Sedation

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16
Q

Ethosuximide

A

Zarontin

T-type Ca channels

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17
Q

Perampanel

A

Fycompa
antagonist of AMPA receptor

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18
Q

Levetiracetam

A

keppra

binds SV2A

depression
renally dosed

19
Q

Felbamate

A

blocks NDMA
GABA enhancement

20
Q

Generalized Seizures

A

Lamotrigine
Levetiracetam
Valproate

Others:
Topiramate
Zonisamide

21
Q

ASMs and depression

A

Positive impact: Carbamazepine, Lamotrigine, Valproate, Lacosamide

Negative: Levetiracetam, Topiramate, Zonisamide

22
Q

Absence Seizures

A

Ethosuximide
Valproate

Other:
Lamotrigine

23
Q

ASM weight gain

A

Valproate
Oxcarbamazepine
Gabapentin
Pregablin

24
Q

Weight loss

A

Zonisamide, topiramate

25
Q

ASMs that do not affect bone density

A

Lamotrigine, levetiracetam, zonisamide

26
Q

Sedation

A

Carbamazepine, Oxcarbamazepine, Phenytoin, Phenobarbital, Topiramate, Tiagabine

26
Q

Oxcarbamazepine

A

Renally dosed
Weight gain
Sedation

27
Q

Tension Headaches (prophylaxis)

A

1st line: non-pharmacological
2: Amitriptyline 30-75 mg nightly

Alternatives:
Mirtazapine 30 mg nightly
Venlafaxine 150 mg nightly

28
Q

Migraines (Acute treatment)

A

1st Line:
analgesics

2nd Line:
Triptans

Alternatives:
CGRPs
Ergots

29
Q

Ergot derivatives

A

Black box warning: ischemia if taken with CYP3A4 inhibitors

Contraindications: PVD, IHD, renal or hepatic impairment

30
Q

Migraines (preventative)

A

1st Line:
Beta-blockers, anticonvulsants, Frovatriptan (for menstrual related migraines only)

2nd Line:
Amitriptyline
Venlafaxine

Alternatives:
CGRP
Botox

31
Q

Cluster Headaches

A

1st Line:
Oxygen therapy

2nd Line:
Sumatriptan
Zolmitriptan

Alternatives:
Intranasal Lidocaine
Ergot

32
Q

Opioids to avoid in renal impairment

A

morphine
hydromorphone

33
Q

Opioids to avoid in hepatic impairment

A

codeine
tramadol
hydrocodone

34
Q

Opioid Tolerance

A

> 60 mg OME for >1 week

35
Q

Codeine DDI

A

CYPD2D6 phenotypes

36
Q

Tramadol DDI

A

CYPD26 & CYP3A4 inducers/inhibitors

CYPD2D6 phenotypes

37
Q

Buprenorphine DDI

A

CYP3A4 inducers/inhibitors

38
Q

Neuropathic pain agents

A

Gabapentinoids, TCAs, SNRIs

38
Q

Tapentadol DDI

A

MAOIs

39
Q

Asthma Diagnosis

A

-FEV1 and FVC increases from baseline by 12% and 200 mL after SABA
-FEV1 increases from baseline by 10% from predicted FEV1 after SABA
-PEF increases by 20% in adults or 15% in children

40
Q

GINA score for adults

A

-Step 1-2: infrequent asthma symptoms or asthma symptoms less than 3-5 days/wk
-Step 3: asthma symptoms most days, waking due to asthma once a week or more
-Step 4: daily asthma symptoms, waking at night, current smokers

41
Q

GINA score for children

A

Step 1: infrequent symptoms (1-2 days/wk)
Step 2: 3-5days/wk
Step 2-3: most days, waking due to asthma
Step 4: daily asthma symptoms

Therapeutics (11 decks)

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