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idt fall > ZJ HA therapeutics > Flashcards

ZJ HA therapeutics Flashcards

1
Q

migraine abortive therapy should not be used more than __ days per month

A

10

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2
Q

every triptan has a short duration of action except for which two?

A

frovatriptan and naratriptan

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3
Q

every triptan has an average onset around 30 minutes except for which two?

A

frovatriptan and naratriptan

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4
Q

what is the time of onset for naratriptan?

A

1-3 hours

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5
Q

what is the time of onset for frovatriptan?

A

2-3 hours

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6
Q

eletriptan is metabolized by which enzyme?

A

3A4

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7
Q

why should SSRIs, SNRIs, and MAOIs be used with caution with triptans?

A

potential risk of serotonin syndrome

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8
Q

are triptans contraindicated with pregnancy?

A

yes

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9
Q

what diseases are triptans contraindicated with?

A

coronary artery disease, uncontrolled hypertension, and peripheral vascular disease

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10
Q

what are the three antiemetics?
what drug class are they?
why can they be used for migraines?

A

chlorpromazine
prochlorperazine
metoclopramide
dopamine antagonists
they have analgesic properties

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11
Q

antiemetics for migraines are only given parentally, however, they have an increased risk of?

A

EPS

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12
Q

what drug is co-prescribed with antiemetics to reduce risk of dystonia?

A

diphenhydramine

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13
Q

what are 2 adverse reactions from chlorpromazine and prochloperazine?

A

postural hypotension and QT prolongation

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14
Q

what’s the key difference between triptans and ergot alkaloids?

A

ergot have more systemic vasoconstriction

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15
Q

which of the ergot alkaloids is mainly used over the other?

A

dihydroergotamine

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16
Q

what is the preferred administration route for dihydroergotamine?

A

either IV or IM

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17
Q

**ergots have same contraindications as triptans

A

.

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18
Q

ergot alkaloids should always be used in combination with?

A

antiemetics

19
Q

what role do corticosteroids have for treating HAs?

A

used either in combination for severe attacks or to decrease rates of HA recurrence

20
Q

corticosteroid use for HAs are only administered via what route?

A

parentally

21
Q

when is it okay to use opioids/barbiturates to treat HAs? If used, therapy should be limited to how many days?

A

last resort if other therapies have failed. use should be limited to 5 days

22
Q

what drug class is lasmiditan?

A

5HT1F receptor agonist

23
Q

T/F lasmiditan, like triptans and ergot alkaloids, can not be used in patients with CV disease

A

False, it is safe

24
Q

what are common SEs of lasmiditan?

A

dizziness and somnolence (drowsiness)

25
Q

what drug class are gepants?

A

CGRP antagonist

26
Q

when/how are gepants given?

A

orally for migraines in patients with either insufficient response or contraindication to treatment with triptans

27
Q

what are the names of the two gepant drugs?

A

ubrogepant
rimegepant

28
Q

what drug classes are used as preventive therapy for migraines?

A

beta blockers and calcium channel blockers
antidepressants
antiepileptics
CGRP antagonists

29
Q

what beta blocker/ calcium channel blocker is commonly used for preventing migraines?

A

metoprolol or propranolol, verapamil

30
Q

what class of antidepressants is most commonly used to prevent migraines?

A

SNRIs

31
Q

which antiepileptics are used to prevent migraines?

A

valproic acid and topiramate

32
Q

which CGRP antagonists are used to prevent migraines? (Every Friend Gives Ritz)

A

erenumab, fremanezumab, galcanezumab, and rimegepant

33
Q

T/F opioids and barbiturates should not be used for acute or preventative treatment of migraines

A

true

34
Q

adverse effects of metoprolol/propranolol?
avoid in patients with?

A

ED, raynauds
asthma, diabetes, and depression

35
Q

adverse effects of verapamil?

A

constipation

36
Q

adverse effects of topiramate?

A

weight loss, paresthesia, cognitive impairment

37
Q

adverse effects of valproic acid?

A

weight gain, thrombocytopenia, alopecia

38
Q

2 adverse effects of CGRP antagonists?

A

angioedemia and anaphylaxis

39
Q

what is botulinum toxin (botox) effective/ineffective for?

A

effective for chronic migraine prevention, ineffective for episodic migraine prevention

40
Q

how do we treat cluster HAs?

A

oxygen plus pharmacological treatment

41
Q

what is first-line therapy for cluster HAs?

A

serotonin agonists

42
Q

what are the 2 treatments for cluster HAs administered intranasally?

A

triptans and lidocaine

43
Q

what are the two meds used for long term preventative treatment of cluster HAs?

A

verapamil or lithium

idt fall (29 decks)

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