Pharm Final study guide
The final exam is comprehensive. 60% new content, 40% older content. The guide below focuses on the
areas of new content.
Different types of headaches, s/sx
Tension- feels like a band around the head/ pulsating
Migraine- unilateral, pulsating, aura, nausea/photophobia, familial
Trigeminal autonomic cephalagias (TACs)
Cluster- around one eye
Headache Warning signs:
Onset after age 50
Abrupt onset
Accelerating headache pattern (severity / frequency)
Associated with neck pain and/or fever
Abnormal neuro exam or radiographs
Treatment of tension headaches, migraines, and cluster
Tension:
1st line
ASA
Acetaminophen
, 2nd line
NSAID
Caffeine containing products
3rd line
Butalbital (Fioricet)containing products
> 2 or more/week – prophylaxis agent
Migraines
ASA
NSAID
Triptans
Ergot Derivatives
Barbiturates/opioids
Steroids
Evaluation and treatment of insomnia
• Diagnosis:
• S&S
• Complete PE to r/o other causes
• Sleep questionnaires
• Goals of Drug Therapy:
, • Promote the ability to fall asleep, maintain sleep, or awaken refreshed
• Use a Rx agent for the shortest time possible
• Hypnotics are the most commonly prescribed drugs to treat insomnia
Barbiturates (amobarbital [Amytal], butabarbital [Secbutabarpital]:
• Mechanism of Action: Interferes with transmission of impulses from the thalamus to the
cortex; depresses sensory cortex and decreases motor activity
• ADE: CNS depression including coma and death
• Interactions: ETOH, BBs, OCP, theophylline, metronidazole, doxycycline
Benzodiazepines (alprazolam [Xanax], lorazepam [Ativan], temazepam [Restoril]):
• Mechanism of Action: binds receptors at several sites within the CNS, including the limbic
system and reticular formation; effects may be mediated through GABA receptor system;
increase in neuronal membrane permeability to chloride ions enhances the inhibitory
effects of GABA; the shift in chloride ions causes hyper polarization (less excitability) and
stabilization of the neuronal membrane
• ADE: drowsiness, impaired motor function, memory loss, dependency
• Interactions: ETOH, OCP, erythromycin
S/Sx of narcolepsy, treatment
Patients with this condition achieve REM in less than 1 minute
Excessive daytime sleepiness x 3 months
• Psychostimulants
• Armodafinil
• Modafinil
The final exam is comprehensive. 60% new content, 40% older content. The guide below focuses on the
areas of new content.
Different types of headaches, s/sx
Tension- feels like a band around the head/ pulsating
Migraine- unilateral, pulsating, aura, nausea/photophobia, familial
Trigeminal autonomic cephalagias (TACs)
Cluster- around one eye
Headache Warning signs:
Onset after age 50
Abrupt onset
Accelerating headache pattern (severity / frequency)
Associated with neck pain and/or fever
Abnormal neuro exam or radiographs
Treatment of tension headaches, migraines, and cluster
Tension:
1st line
ASA
Acetaminophen
, 2nd line
NSAID
Caffeine containing products
3rd line
Butalbital (Fioricet)containing products
> 2 or more/week – prophylaxis agent
Migraines
ASA
NSAID
Triptans
Ergot Derivatives
Barbiturates/opioids
Steroids
Evaluation and treatment of insomnia
• Diagnosis:
• S&S
• Complete PE to r/o other causes
• Sleep questionnaires
• Goals of Drug Therapy:
, • Promote the ability to fall asleep, maintain sleep, or awaken refreshed
• Use a Rx agent for the shortest time possible
• Hypnotics are the most commonly prescribed drugs to treat insomnia
Barbiturates (amobarbital [Amytal], butabarbital [Secbutabarpital]:
• Mechanism of Action: Interferes with transmission of impulses from the thalamus to the
cortex; depresses sensory cortex and decreases motor activity
• ADE: CNS depression including coma and death
• Interactions: ETOH, BBs, OCP, theophylline, metronidazole, doxycycline
Benzodiazepines (alprazolam [Xanax], lorazepam [Ativan], temazepam [Restoril]):
• Mechanism of Action: binds receptors at several sites within the CNS, including the limbic
system and reticular formation; effects may be mediated through GABA receptor system;
increase in neuronal membrane permeability to chloride ions enhances the inhibitory
effects of GABA; the shift in chloride ions causes hyper polarization (less excitability) and
stabilization of the neuronal membrane
• ADE: drowsiness, impaired motor function, memory loss, dependency
• Interactions: ETOH, OCP, erythromycin
S/Sx of narcolepsy, treatment
Patients with this condition achieve REM in less than 1 minute
Excessive daytime sleepiness x 3 months
• Psychostimulants
• Armodafinil
• Modafinil
