Week 12

Question 1

Epilepsy classified as:

Answer 1

More than 2 unprovoked seizures

Question 2

What type of seizure do patients always lose consciousness?

Answer 2

Generalized

Question 3

What seizure med is absolutely contraindicated in pregnancy?

Answer 3

Valproate

Question 4

Women taking an enzyme-inducing anti seizure drug including lamotrigne should not use:

Answer 4

Contraception in the form of a hormonal pill, patch, or ring.
May use: copper or mirena IUD or implant

Question 5

In Parkinson’s disease dopamine is only effective for:

Answer 5

Motor symptoms

Question 6

What is initial therapy for Parkinson’s disease?

Answer 6

Carbidopa-levodopa- May lessen in effectiveness over time but is most effective- start when PD impacts quality of life

Question 7

If you overshoot with carbidopa-levodopa what are the symptoms:

Answer 7

Dystonia
Dyskinesia
Psychosis

Question 8

If you undershoot with Carbidopa-levodopa what are the symptoms?

Answer 8

Tremor
Rigidity
Bradykinesia
Gait/balance

Question 9

Dopamine agonist are used in PD:

Answer 9

Typically early for motor symptoms

Question 10

Examples of dopamine agonist:

Answer 10

Pramipexole

Ropinirole

Question 11

Dopamine agonists should not be used in:

Answer 11

People with addiction or history of addiction because dopamine has a pleasure seeking quality

Question 12

MAO-B inhibitors and catechol-O-methyltransferase inhibitors are used in PD:

Answer 12

To extend the effects of individual doses of carbidopa-levodopa, decrease the on-off phenomena

Question 13

What is the initial therapy for insomnia?

Answer 13

Nonpharmacologic interventions such as sleep hygiene, stimulus control therapy, and sleep restriction therapy.

Question 14

Before starting pharmacological interventions in Alzheimer’s this should be done:

Answer 14

All nonpharmacologic interventions should be in place and maximized such as exercise, cognitive rehab, social and cognitive stimulation, and structured support.

Question 15

Pharmacologic agents only Alzheimer’s:

Answer 15

Cholinesterase inhibitors- start early on

NMDA antagonists- moderate to severe AD

Question 16

Cholinesterase inhibitors are used in AD:

Answer 16

Mild-moderate impairment 
Work more for memory and attention 
Do not reverse cognitive loss
Slow progression 
Examples: donepizil (aricept)

Question 17

NMDA antagonists are used in AD for:

Answer 17

Moderate-severe AD

Can be used with cholinesterase inhibitors

Question 18

Red flags with headaches:

Answer 18

New headache after 40
Severe headache with exertion 
Neuro changes including memory or cognition 
Infection
Trauma

Question 19

Most common episodic headache:

Answer 19

Migraine

Question 20

Treatment for migraine:

Answer 20

Avoid triggers
Abortive treatment: 5-HT agonists (triptans)
Preventative: BB (propranolol), TCAs, CCB, anticonvulsants (valproate and gabapentin)

Question 21

Treatment for menstrual migraine:

Answer 21

Standard abortive therapy

Preventative strategy to avoid drop in estrogen

Question 22

Narrow spectrum antiepilectic meds are used for:

Answer 22

Focal seizures

Question 23

Broad spectrum antiepilectic medications are used for:

Answer 23

Both focal and generalized

Question 24

Cluster headaches are:

Answer 24

More common in men than women with a history of heavy alcohol and tobacco use.
Includes lacrimation and rhinorrhea

Question 25

Triptans MOA:

Answer 25

Act as selective serotonin receptor agonist and work at the 5-HT1D serotonin receptors site allowing for increased uptake of serotonin.

Question 26

Triptans are used in cation:

Answer 26

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