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Details

pirotte Pharm
mackin HA/epilepsy
86
Other
Not Applicable
09/25/2005

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Cards

Term
2ndary HA warning sign #?
Definition
single HA
Term
2ndary HA warning sign onset?
Definition
sudden
Term
2ndary HA warning sign age?
Definition
50+
Term
2ndary HA warning sign systemic?
Definition
fever, myalgia, weight loss
Term
2ndary HA warning sign concommitant disease?
Definition
AIDS, malignancy
Term
2ndary HA warning sign pattern?
Definition
progressive, freq/severity
Term
2ndary HA warning sign PE?
Definition
neuro exam abnml
Term
classes of meds specific for migraines?
Definition
triptans, egot alkaloids
Term
2+ of the following for dx migraine
Definition
pulsating, unilateral, mod/severe pain, aggravated by routine activity
Term
1+ of the following for dx migraine
Definition
n+v, photo/phonophobia
Term
some manifestations of aura
Definition
soctoma, scintillations, hemipar, numb, dysasthesia
Term
sx of tension HA
Definition
dull, nonpulsatile pain, pressure, not aggravated by activity, only one of N/photo/phonophobia
Term
can a pt have photo/phonophobia and not have a migraine?
Definition
yes, if only one is present
Term
classic age/sex for cluster HAs?
Definition
men, 20s, 30s
Term
associated neuro sx with cluster HAs?
Definition
ipsilaters autonomic
Term
NT implicated in migraine?
Definition
5HT
Term
5HTR for migraine therapy?
Definition
5HT 1A,B,D
Term
how might reserpine trigger a migraine?
Definition
it would deplete 5HT
Term
why might sleep trigger a migraine?
Definition
dorsal raphe cells quit releaseing 5HT
Term
effect of 5HT1DR?
Definition
CNS inhibition
Term
effect of5HT1BR?
Definition
smooth muscle relax
Term
mech of triptans?
Definition
5HT1B,DR agonists
Term
triptan response at 2 hours?
Definition
66% response, 30% relief
Term
MOA triptan (not just receptor specificity)
Definition
cranial vasoconstriction, neuronal inhibition
Term
what cranial nerve has been implicated in migraine?
Definition
V
Term
SE of triptans
Definition
dizzy, somnelent, fatigue, parasthesia, chest sx
Term
contraindications for triptans
Definition
CARDIAC OR PER VASC DISEASE OR HTN, hepatic impairment, SSRI, breastfeeding
Term
proposed MOA of ergot alkaloids
Definition
inhibit neurogenic inflammation
Term
receptors for ergot alkaloids
Definition
5HT1,2
Term
big SE of ergot alkaloids
Definition
N+V
Term
contraindications for EA?
Definition
cardiac/vascular issues
Term
what sort of migraine should not be treated with triptans or EAs?
Definition
hemiplegic/basilar
Term
SE of valproate?
Definition
weight gain
Term
"SEs" of topiramate?
Definition
weight loss, cog impair
Term
gen classes for migraine prevention
Definition
anticonv, AD, BB, CCB, NSAIDs, ser antagonists
Term
discuss the "complex role of serotonin in migraine" as it is proven by migraine rx...
Definition
antagonists for prevention, agonists for treatment
Term
biggie rx for cluster HA?
Definition
100% O2, 6L/min
Term
prevention of cluster HA?
Definition
Li, BB, CCB
Term
contraindication for Li?
Definition
nephro DI, thyroid, tremor
Term
contraindication for BB?
Definition
heart disease, brady, DMI
Term
CCB for cluster HA?
Definition
verapamil
Term
rx for tension HA?
Definition
follow pain ladder
Term
prevention of tension HA?
Definition
TCA, anticonv, muscle relax
Term
what is the most commonly removed seizure focus?
Definition
part of non-dom temporal lobe
Term
older AConv?
Definition
phenobarb, phenytoin, ethosuxamide, carbemazepine, divalproex Na
Term
anticonvulsive inhibitors of CYP450
Definition
valproate
Term
anticonvulsive inducers of CYP450
Definition
all the oldies except valproate
Term
thing to remember with carbemazepine?
Definition
it autoinduces its own metabolism
Term
what's the deal with felbamate?
Definition
it is an newer ACNV with serious side effects, a "last-ditch" option
Term
main rx of gabapentin?
Definition
neuropathic pain
Term
drug of choice for all types of seizure?
Definition
valproate
Term
drug of choice for partial w/ or w/o 2ndary GTC?
Definition
carb, phen, valp, pheno
Term
drug of choice for primary GTC?
Definition
val, phen, pheno
Term
drug of choice for abscence?
Definition
etho, valp
Term
drug of choice for atypical absence, myoclonic, or atonic seizure?
Definition
valp
Term
why must you monitor ACNVs closely?
Definition
narrow therapeutic window
Term
which ACNVs have high plasma protein binding?
Definition
phen, val, clonazepam
Term
MOA phenytoin
Definition
Na blocker, inhibition repetitive APs
Term
use of phenytoin
Definition
partial seizure, GTC
Term
why is there not a linear dose/plasma conc relationship with phenytoin?
Definition
liver can be saturated
Term
big interaction with phenytoin
Definition
warfarin
Term
SE of phenytoin
Definition
EtOH like, gingival hyperplasia, hirsuitism, terato, RASH
Term
class of carbemazepine?
Definition
TCA
Term
MOA carbemazepine
Definition
Na blocker
Term
clinical use of carbemazepine
Definition
partial seizure, 2dary GTC, V neuralgia, mania/mood
Term
SE of carbemazepine
Definition
neuro stuff (diplopia, ataxia), GI, rash, BONE MARROW SUPPRESSION, nausea, sedation, hypoNa
Term
MOA phenobarbital
Definition
duration of Cl
Term
clinical use of phenobarbital
Definition
partial seizure, GTC
Term
SE of phenobarbital
Definition
sed/drow, cog impair, TERATOGEN
Term
action of primidone
Definition
metabolized into 3 ACNV including pheno
Term
MOA ethosux
Definition
dec Ca T-type transport
Term
clinic use of ethosux
Definition
ABSCENCE
Term
SE of ethosux
Definition
gastric, HA, N+V, eosinophilia, leukopenia, SLE (rare)
Term
MOA valproate
Definition
dec Na conductance, inhibit GABA catabolism
Term
clinic use of valpro
Definition
all seizures, bipolar, migraine prophylaxis
Term
clinical use of clonazepam?
Definition
myoclonic/abscence
Term
big SE with lamotrigine
Definition
StevensJohnson rash
Term
advantages of gabapentin
Definition
few SE, no interaction
Term
big SE of topiramate
Definition
cog impariment
Term
what is the most common add-on AED and why?
Definition
levetiracetam, no protein binding, no hepatic metabolism
Term
action of oxcarb?
Definition
block Na
Term
action of lamotrigine?
Definition
block Na
Term
action of topiramate
Definition
NMDA blocker
Term
action of zonisamide
Definition
T-type Ca channels
Term
action of levetiracetam
Definition
K blocker, Ca blocker
Term
duration of abscence seizure?
Definition
30s
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