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74 Cards in this Set

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  • Back
what is sumatriptan used for
acute migraine, cluster headache attacks
what is the mechanism of sumatriptan
5-HT1D agonist
what is the half life of sumatriptan
less than 2 hours
what are the side effects of sumatriptan
chest discomfort, mild tingling
what are the contraindications for sumatriptan
patients with CAD or Prinzmetal's angina
which drugs are used for simple and complex partial seizures
phenytoin, carbamazapine, lamotrigine, gabapentin, topiramate
what types of seizures is phenytoin indicated for
simple and complex partial, tonic-clonic (1st line), status epilepticus (1st line for prophylaxis)
what types of seizures is carbamazepine indicated for
simple and complex partial, tonic-clonic, trigeminal neuralgia
what types of seizures is lamotrigine indicated for
simple and complex partial, tonic-clonic
what types of seizures is gabapentin indicated for
simple and complex partial, tonic-clonic
what types of seizures is topiramate indicated for
simple and complex partial, tonic clonic
what types of seizures is phenobarbital indicated for
simple and complex partial, tonic clonic
what drugs can be used for tonic-clonic seizures
phenytoin (1st line), carbamazapine (1st line), lamotrigine, gabapentin, phenobarbital (first line pregnat women & children), valproate (1st line)
what drugs can be used for absence seizures
valproate, ethosuximide
what drugs can be used for status epilepticus
phenytoin (prophylaxis), benzodiazapines (acute; diazepam, lorazepam)
what types of seizure is valproate indicated for
partial, tonic-clonic, absence
what types of seizure is ethosuximide inidcated for
absence
what type of seizure are benzodiazepines indicated for
status epilepticus
other than anti-seizure, what else is phenytoin used for
class 1B anti-arrhythmic
how should a patient taking carbamazepine be followed
monitor LFT's weekly
which seizure drugs have adjunct use
gabapentin, topiramate
which seizure drug is safest in pregnant women
phenobarbital
which seizure drug is used in Crigler-Najjar II
phenobarbital
what are the advantages of phenobarbital
can be used in pregnant women, Crigler Najjar II
what are the side effects of benzodiazepines
sedation, tolerance, dependence
what are the side effects of carbamazepine
diplopia, ataxia, CYP induction, blood dyscrasias, liver toxicity
what are the side effects of ethosuximide
GI distress, lethargy, headache, urticaria, Stevens-Johnson syndrome
what are the side effects of phenobarbital
sedation, CYP induction, tolerance, dependence
what are the side effects of phenytoin
nystagmus, diplopia, ataxia, sedation, ginigival hyperplasia, hirsutism, anemias, teratogenic
what are the side effects of valproate
GI distress, rare by fatal hepatotoxicity, neural tube defects (spina bifida)
what are the side effects of lamotrigine
life-threatening rash, Stevens-Johnson syndrome
what are the side effects of gabapentin
sedation, movement disorders
what are the side effects of topiramate
sedation, mental dulling, kidney stones, weight loss
which anti-epileptic drug is teratogenic
phenytoin (valproate neural tube defects)
which anti-epileptic drug can cause dependence
benzodiazepines, phenobarbital
which anti-epileptic drug can cause neural tube defects
valproate
which anti-epileptic drugs can cause GI distress
valproate, ethosuximide
it is necessary to check LFT's with which anti-epileptic drugs
carbamazepine, valproate
which anti-epileptic drugs cause CYP induction
phenobarbital, carbamazepine
which anti-epileptic drugs can cause blood problems
carbamazepine (agranulocytosis, aplastic anemia), phenytoin (megaloblastic anemia)
which anti-epileptic drugs can cause Stevens-Johnson syndrome
Lamotrigine, ethosuximide
which anti-epileptic drugs can cause diplopia
carbamazepine, phenytoin
what is the mechanism of phenytoin action
use-dependent blockade of Na+ channels
what is the clinical application of phenytoin
first line tonic clonic; partial, prophylaxis for status epilepticus
what are the toxicities of phenytoin
nystagmus, ataxia, diplopia, lethargy, SLE like syndrome, induce P450
what are the chronic toxicities of phenytoin
gingival hyperplasia in children, peripheral neuropathy, hirsutism, megaloblastic anemia, malignant hyperthermia (rare)
should pregnant women take phenytoin
NO -- teratogenic
why does phenytoin cause megaloblastic anemia
causes decreased vitamin B-12
name 4 barbiturates
phenobarbital, pentobarbital, thiopental, secobarbital
what is the mechanism of barbiturate action
increase duration of Cl channel opening --> decreased neuron firing --> facilitate GABA-A action
how do barbiturates facilitate GABA-A action
increase duration of Cl channel opening which decreases neuron firing (benzos increase frequency)
is barbiturate action on the CNS stimulatory or inhibitory
inhibitory
what is the clinical application of barbiturates
sedative for anxiety, seizures, insomnia, anesthesia induction (thiopental)
which barbiturate is used for anesthesia induction
thiopental
what are the side effects of barbiturates
dependence, additive CNS depression effects with alcohol, respiratory or CV depression (death), drug interactions due to CYP induction
what should you find out before giving a patient barbiturates
what other medications they take, because of CYP induction and many drug interactions
what happens if you give barbiturates to a patient in alcohol-induced coma or DT's
they might DIE!! Because of additive effect of barbiturates and alcohol --> respiratory depression
when are barbiturates contra-indicated
porphyria
can barbiturates cause dependence
YES
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
clinical pharmacology made ridiculous. Period
name a bunch of benzodiazepines
diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide (all have ZZZ in them)
what is the mechanism of benzodiazepines
increase frequency of Cl channel opening --> facilitate GABA-A action (Frenzodiazepines increase frequency)
which GABA receptors are facilitated by barbiturates and bezodiazepines
GABA-A
what are the clinical applications of benzodiazepines
anxiety, spasticity, status epilepticus (diazepam), detoxification (alcohol withdrawal, DT's)
which benzodiazepine can be used for status epilepticus
diazepam
what drugs can be used to treat alcohol withdrawal
benzodiazepines
which benzodiazepines are short-acting
TOM thumb: Triazolam, Oxazepam, Midazolam
what are the toxic effects of benzos
dependence, additive CNS depression effects with alcohol
how are benzos better than barbiturates
less respiratory depression and coma risk
how do you treat benzo overdose
flumazenil
what is flumzenil used for
benzo overdose
how does flumazenil work
competitive antagonist at GABA receptor
can a patient become benzodiazepine dependent
YES
are barbiturates or benzodiazepines used for alcohol withdrawal
benzodiazepines