Week 12 Flashcards
Epilepsy classified as:
More than 2 unprovoked seizures
What type of seizure do patients always lose consciousness?
Generalized
What seizure med is absolutely contraindicated in pregnancy?
Valproate
Women taking an enzyme-inducing anti seizure drug including lamotrigne should not use:
Contraception in the form of a hormonal pill, patch, or ring.
May use: copper or mirena IUD or implant
In Parkinson’s disease dopamine is only effective for:
Motor symptoms
What is initial therapy for Parkinson’s disease?
Carbidopa-levodopa- May lessen in effectiveness over time but is most effective- start when PD impacts quality of life
If you overshoot with carbidopa-levodopa what are the symptoms:
Dystonia
Dyskinesia
Psychosis
If you undershoot with Carbidopa-levodopa what are the symptoms?
Tremor
Rigidity
Bradykinesia
Gait/balance
Dopamine agonist are used in PD:
Typically early for motor symptoms
Examples of dopamine agonist:
Pramipexole
Ropinirole
Dopamine agonists should not be used in:
People with addiction or history of addiction because dopamine has a pleasure seeking quality
MAO-B inhibitors and catechol-O-methyltransferase inhibitors are used in PD:
To extend the effects of individual doses of carbidopa-levodopa, decrease the on-off phenomena
What is the initial therapy for insomnia?
Nonpharmacologic interventions such as sleep hygiene, stimulus control therapy, and sleep restriction therapy.
Before starting pharmacological interventions in Alzheimer’s this should be done:
All nonpharmacologic interventions should be in place and maximized such as exercise, cognitive rehab, social and cognitive stimulation, and structured support.
Pharmacologic agents only Alzheimer’s:
Cholinesterase inhibitors- start early on
NMDA antagonists- moderate to severe AD
Cholinesterase inhibitors are used in AD:
Mild-moderate impairment Work more for memory and attention Do not reverse cognitive loss Slow progression Examples: donepizil (aricept)
NMDA antagonists are used in AD for:
Moderate-severe AD
Can be used with cholinesterase inhibitors
Red flags with headaches:
New headache after 40 Severe headache with exertion Neuro changes including memory or cognition Infection Trauma
Most common episodic headache:
Migraine
Treatment for migraine:
Avoid triggers
Abortive treatment: 5-HT agonists (triptans)
Preventative: BB (propranolol), TCAs, CCB, anticonvulsants (valproate and gabapentin)
Treatment for menstrual migraine:
Standard abortive therapy
Preventative strategy to avoid drop in estrogen
Narrow spectrum antiepilectic meds are used for:
Focal seizures
Broad spectrum antiepilectic medications are used for:
Both focal and generalized
Cluster headaches are:
More common in men than women with a history of heavy alcohol and tobacco use.
Includes lacrimation and rhinorrhea
Triptans MOA:
Act as selective serotonin receptor agonist and work at the 5-HT1D serotonin receptors site allowing for increased uptake of serotonin.
Triptans are used in cation:
In patients with angina or high risk of CAD, pregnant women, patients who have recently used ergots.
Used in caution with MAOIs and high dose SSRIs
