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74 Cards in this Set
- Front
- Back
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what is sumatriptan used for
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acute migraine, cluster headache attacks
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what is the mechanism of sumatriptan
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5-HT1D agonist
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what is the half life of sumatriptan
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less than 2 hours
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what are the side effects of sumatriptan
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chest discomfort, mild tingling
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what are the contraindications for sumatriptan
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patients with CAD or Prinzmetal's angina
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which drugs are used for simple and complex partial seizures
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phenytoin, carbamazapine, lamotrigine, gabapentin, topiramate
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what types of seizures is phenytoin indicated for
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simple and complex partial, tonic-clonic (1st line), status epilepticus (1st line for prophylaxis)
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what types of seizures is carbamazepine indicated for
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simple and complex partial, tonic-clonic, trigeminal neuralgia
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what types of seizures is lamotrigine indicated for
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simple and complex partial, tonic-clonic
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what types of seizures is gabapentin indicated for
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simple and complex partial, tonic-clonic
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what types of seizures is topiramate indicated for
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simple and complex partial, tonic clonic
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what types of seizures is phenobarbital indicated for
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simple and complex partial, tonic clonic
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what drugs can be used for tonic-clonic seizures
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phenytoin (1st line), carbamazapine (1st line), lamotrigine, gabapentin, phenobarbital (first line pregnat women & children), valproate (1st line)
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what drugs can be used for absence seizures
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valproate, ethosuximide
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what drugs can be used for status epilepticus
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phenytoin (prophylaxis), benzodiazapines (acute; diazepam, lorazepam)
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what types of seizure is valproate indicated for
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partial, tonic-clonic, absence
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what types of seizure is ethosuximide inidcated for
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absence
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what type of seizure are benzodiazepines indicated for
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status epilepticus
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other than anti-seizure, what else is phenytoin used for
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class 1B anti-arrhythmic
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how should a patient taking carbamazepine be followed
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monitor LFT's weekly
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which seizure drugs have adjunct use
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gabapentin, topiramate
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which seizure drug is safest in pregnant women
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phenobarbital
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which seizure drug is used in Crigler-Najjar II
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phenobarbital
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what are the advantages of phenobarbital
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can be used in pregnant women, Crigler Najjar II
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what are the side effects of benzodiazepines
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sedation, tolerance, dependence
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what are the side effects of carbamazepine
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diplopia, ataxia, CYP induction, blood dyscrasias, liver toxicity
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what are the side effects of ethosuximide
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GI distress, lethargy, headache, urticaria, Stevens-Johnson syndrome
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what are the side effects of phenobarbital
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sedation, CYP induction, tolerance, dependence
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what are the side effects of phenytoin
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nystagmus, diplopia, ataxia, sedation, ginigival hyperplasia, hirsutism, anemias, teratogenic
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what are the side effects of valproate
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GI distress, rare by fatal hepatotoxicity, neural tube defects (spina bifida)
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what are the side effects of lamotrigine
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life-threatening rash, Stevens-Johnson syndrome
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what are the side effects of gabapentin
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sedation, movement disorders
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what are the side effects of topiramate
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sedation, mental dulling, kidney stones, weight loss
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which anti-epileptic drug is teratogenic
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phenytoin (valproate neural tube defects)
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which anti-epileptic drug can cause dependence
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benzodiazepines, phenobarbital
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which anti-epileptic drug can cause neural tube defects
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valproate
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which anti-epileptic drugs can cause GI distress
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valproate, ethosuximide
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it is necessary to check LFT's with which anti-epileptic drugs
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carbamazepine, valproate
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which anti-epileptic drugs cause CYP induction
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phenobarbital, carbamazepine
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which anti-epileptic drugs can cause blood problems
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carbamazepine (agranulocytosis, aplastic anemia), phenytoin (megaloblastic anemia)
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which anti-epileptic drugs can cause Stevens-Johnson syndrome
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Lamotrigine, ethosuximide
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which anti-epileptic drugs can cause diplopia
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carbamazepine, phenytoin
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what is the mechanism of phenytoin action
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use-dependent blockade of Na+ channels
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what is the clinical application of phenytoin
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first line tonic clonic; partial, prophylaxis for status epilepticus
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what are the toxicities of phenytoin
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nystagmus, ataxia, diplopia, lethargy, SLE like syndrome, induce P450
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what are the chronic toxicities of phenytoin
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gingival hyperplasia in children, peripheral neuropathy, hirsutism, megaloblastic anemia, malignant hyperthermia (rare)
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should pregnant women take phenytoin
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NO -- teratogenic
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why does phenytoin cause megaloblastic anemia
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causes decreased vitamin B-12
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name 4 barbiturates
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phenobarbital, pentobarbital, thiopental, secobarbital
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what is the mechanism of barbiturate action
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increase duration of Cl channel opening --> decreased neuron firing --> facilitate GABA-A action
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how do barbiturates facilitate GABA-A action
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increase duration of Cl channel opening which decreases neuron firing (benzos increase frequency)
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is barbiturate action on the CNS stimulatory or inhibitory
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inhibitory
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what is the clinical application of barbiturates
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sedative for anxiety, seizures, insomnia, anesthesia induction (thiopental)
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which barbiturate is used for anesthesia induction
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thiopental
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what are the side effects of barbiturates
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dependence, additive CNS depression effects with alcohol, respiratory or CV depression (death), drug interactions due to CYP induction
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what should you find out before giving a patient barbiturates
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what other medications they take, because of CYP induction and many drug interactions
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what happens if you give barbiturates to a patient in alcohol-induced coma or DT's
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they might DIE!! Because of additive effect of barbiturates and alcohol --> respiratory depression
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when are barbiturates contra-indicated
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porphyria
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can barbiturates cause dependence
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YES
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My friend Barb was very anxious so her doctor gave her barbiturates to increase the duration of the time she could speak in public without freaking out and having a seizure. She became so dependent on it that she recommended it to her friend Portia who couldn't take it because of porphyria. One day Barb drank too much alcohol and took her barbiturates and never woke up! THE END
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clinical pharmacology made ridiculous. Period
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name a bunch of benzodiazepines
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diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide (all have ZZZ in them)
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what is the mechanism of benzodiazepines
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increase frequency of Cl channel opening --> facilitate GABA-A action (Frenzodiazepines increase frequency)
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which GABA receptors are facilitated by barbiturates and bezodiazepines
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GABA-A
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what are the clinical applications of benzodiazepines
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anxiety, spasticity, status epilepticus (diazepam), detoxification (alcohol withdrawal, DT's)
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which benzodiazepine can be used for status epilepticus
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diazepam
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what drugs can be used to treat alcohol withdrawal
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benzodiazepines
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which benzodiazepines are short-acting
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TOM thumb: Triazolam, Oxazepam, Midazolam
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what are the toxic effects of benzos
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dependence, additive CNS depression effects with alcohol
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how are benzos better than barbiturates
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less respiratory depression and coma risk
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how do you treat benzo overdose
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flumazenil
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what is flumzenil used for
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benzo overdose
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how does flumazenil work
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competitive antagonist at GABA receptor
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can a patient become benzodiazepine dependent
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YES
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are barbiturates or benzodiazepines used for alcohol withdrawal
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benzodiazepines
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