Indications / First-Line / Contraindications Flashcards Preview

Pharmacology II - EXAM 2 > Indications / First-Line / Contraindications > Flashcards

Flashcards in Indications / First-Line / Contraindications Deck (93)
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1

What is indicated for mild to moderate HA treatment?

Acetaminophen
NSAIDs

2

What class of medications is considered first-line for headache treatment?

Triptans
Erogotamines

3

Triptans are specifically first line for treatment of migraines with and without what?

Aura

4

What are contraindications to Triptan use?

Basilar Migraine
Ischemic Events
Unctonrlled HTN
Liver Disease

5

What are TWO indications for DHE use?

Acute migraine with or without aura
Cluster Headaches

6

T/F: Ergotamines can be used as both abortive and prophylaxis in vascular headache treatment

True

7

Should ergotamines be used in patients with Renal Failure, Hepatice Failure, or Vascular disease?

No

8

Are ergotamines safe in pregnancy or breast feeding?

No

9

What is considered second line for headache treatment?

Butorhpanol

10

What is considered third line for headache treatment?

Fiorinal (Butalbital, aspirin, caffeine)
Fioricet (Butalbital, acetaminophen, caffeine)

11

Fiorinal and Fioricet are indicated to treat which type of headache?

Tension-type headache

12

Which for medications have the highest level of evidence for migraine treatment (considered Class A)?

NSAIDs
Triptans
Opiates
Nasal DHE

13

If at home treatment or typical remedies for headache fail.......

What medications can be given?

1. IV DHE + Metoclopramide
2. IV/IM Lorazepam (Ativan)
3. IV Divalproex
4. IM Ketorolac
5. Steroids

14

What is the "typical" first line headache remedy in the ED?

IV Metoclopramide
SubQ Sumatriptan

15

What is the "typical" second line headache remedy in the ED?

What should be avoided?

IV APAP, ASA, Diclofenac, or Ketorolac

Avoid:

Diphenhydramie
Hydromorphone
Lidocaine
Morphine
Octreotide

16

What can be used to treat migraines in pediatric patients?

NSAIDs
Sumatriptan (Nasal, SubQ)
Oral Zolmitriptan or Rizatriptan

17

What medications are considered for migraine prophylaxis?

Divalproex Sodium
Topiramate
Propanolol, Metoprolol, Timolol (Oral)

18

What medication is used for prophylaxis of menstrual migraines?

Frovatriptan

19

What is the most commonly used natural treatment for migraine prophylaxis?

How is this dosed?

Butterbur

1. 75 mg daily for 2-6 months until headaches diminish
2. Then 3-6 months after headaches diminish
3. Gradual taper to discontinuation following that

20

What is first-line for relapsing-remitting MS attacks?

Interferon Beta
Dimethyl Fumarate
Glatiramer Acetate

21

Which MS drug is indicated for......

Reducing neurologic disability
Reducing relapse frequency
RRMS and progressive MS

AND....

Hormone-refractory prostate CA
Acute nonlymphocytic Leukemia in adults

Mitoxantrone

22

What is first line for acute MS attacks?

Glucocorticoids

23

What is first-line for Secondary Progressive or Progressive Relapsing MS?

Interferon beta
Natalizumab
Mitroxantrone

24

Is Glatiramer Acetate an immunomodulator or immunosuppressant?

Immunomodulator

25

Is Mitoxantrone an immunomodulator or immunosuppressant?

Immunosuppressant

26

What MS medication is indicated to reduce exacerbation and delay disability, but is NOT considered first line?

This is used in combination with what medication?

What other disease is this used to treat?

Natalizumab

Used in combo with Interferon Beta

this is also used to treat Crohn's disease

27

What MS medication is indicated to reduce exacerbation and delay disability in relapsing MS, but is associated with first-dose bradycardia?

Fingolimod

28

What MS medication is indicated for relapsing MS, but has major side effects such as hepatotoxicity, teratogencitiy, and bone marrow suppression?

Teriflunomide

29

What medication is indicated to improve walking in MS patients?

In what conditions is this contraindicated?

Dalfampridine

Contraindications:

Renal Impairment
Seizures

30

What muscle relaxant is sometimes used in MS patients which is also FIRST LINE for Malignant Hyperthermia?

Dantrolene