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PR3153 > IC13 > Flashcards

IC13 Flashcards

1
Q

Generic name for LIORESAL

A

baclofen

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2
Q

Intrathecal administration of LIORESAL cause Baclofen conc in CSF to be ____ times higher compared to oral administration

A

100 times

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3
Q

Because of slow CSF circulation and a baclofen concentration gradient from the___ to the____ CSF, the PK parameters should be interpreted considering a___

A

lumbar; cisternal; high inter- and intra-patient variability

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4
Q

How is intrathecal baclofen cleared?

A

via bulk-flow removal of CSF

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5
Q

LIORESAL: Direct infusion into the spinal subarachnoid space bypasses absorption processes and allows exposure to the _____.

A

receptor sites in the dorsal horn of the spinal cord

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6
Q

LIORESAL: indication

A
  • Management of severe spasticity due to spinal cord injury or multiple sclerosis who are unresponsive to oral baclofen or who experience unacceptable side effects at effective oral doses.
  • alternative to destructive neurosurgical procedures.
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7
Q

LIORESAL: can it be administered via parenteral routes e.g. IV,IM other than intrathecal?

A

No

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8
Q

What device is used to administer LIORESAL?

A

implantable pump

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9
Q

LIORESAL: adverse effects

A

life-threatening CNS depression, cardiovascular collapse and/or respiratory failure

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10
Q

What can be observed at the tip of implanted catheter with LIORESAL* Intrathecal? What are the consequences?

A

Inflammatory mass; decreased therapeutic response, pain and serious neurological impairment

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11
Q

Early symptoms of baclofen withdrawal may include ____

A

return of baseline spasticity, pruritus, hypotension, and paresthesias

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12
Q

Advanced LIORESAL* Intrathecal withdrawal syndrome may resemble _____

A

autonomic dysreflexia, infection (sepsis), malignant hyperthermia, neuroleptic-malignant syndrome, or other conditions associated with a hypermetabolic state or widespread rhabdomyolysis.

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13
Q

Caution use of LIORESAL* Intrathecal in patients with renal impairment because baclofen is _____.

A

primarily excreted unchanged through the kidneys

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14
Q

LIORESAL: storage

A

Protect from heat (store at 15-30°C). Do not freeze. Do not heat sterilize.

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15
Q

LIORESAL: Each ampoule is intended for___ use only.

A

single

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16
Q

If LIORESAL is to be diluted, what diuent to use?

A

sterile preservative-free sodium chloride injection (under aseptic condition)

17
Q

Can dextrose be mixed with LIORESAL?

A

No, incompatible

18
Q

Can LIORESAL be mixed with other infusion or injection solutions?

A

No

19
Q

LIORESAL: very common side effects

A

Drowsiness, muscle weakness

20
Q

PRIALT: Generic name

A

ziconotide

21
Q

MOA for PRIALT

A

Blocks N-type calcium channel located on the primary nociceptive (A-δ and C) afferent nerves in the superficial layers (Rexed laminae I and II) of the dorsal horn in the spinal cord

22
Q

Indication for PRIALT

A

management of severe chronic pain (if pt is intolerant or refractory to other tx)

23
Q

Can PRIALT be administered IV?

A

No

24
Q

PRIALT: Saline solutions containing___ are NOT appropriate for intrathecal drug administration and should not be used due to risk of _____.

A

preservatives; neurotoxicity

25
Q

Special administration instruction for PRIALT

A

Refrigerate but do not freeze all PRIALT solutions after preparation and begin infusion within 24 hours.

26
Q

What kind of molecule is ziconotide?

A

peptide

27
Q

Is ziconotide expected to have CYP interactions?

A

No, ziconotide is a peptide, it is expected to be completely degraded by endopeptidases and exopeptidases (Phase I hydrolytic enzymes)

28
Q

Is ziconotide highly ptn bound?

A

No, not highly bound in plasma (approximately 50%) and has low plasma exposure following intrathecal administration

29
Q

Device used for ziconotide administration

A

an appropriate microinfusion device
*Medtronic SynchroMed® II Infusion System or CADD-Micro Ambulatory Infusion Pump.

30
Q

PRIALT: storage

A
  • Refrigerate PRIALT during transit.
  • Store PRIALT at 2°C to 8°C (36°F to 46°F).
  • PRIALT, once diluted aseptically with saline, may be stored at 2°C to 8°C for 24 hours.
  • Do NOT freeze PRIALT.
  • Protect from light.
31
Q

Intradermal delivers drug into the ___

A

epidermis

32
Q

Examples of efflux tpt at BBB

A

BCRP, PGP, MDRP

PR3153 (17 decks)

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