NR566 Advanced Pharmacology for Care of the Family

patient teaching with Phenytoin - strict adherence to medication is important due to its narrow therapeutic range patient teaching regarding anti-seizure meds and OC/pregnancy: - effectiveness of OC may be decreased by many anti-seizure meds, if pregnancy is unwanted the pt should consider adding or increasing contraception. lowest dose/lowest number of meds used during pregnancy tends to be most safe. Risk vs benefit! Folic acid is essential How to monitor antiepileptic drugs for effectiveness? - Monitoring plasma drug levels and absence of seizures during trial period while finding right medication. Patient should not drive during this time What is abortive migraine therapy and when is it used - analgesics (NSAID and opioid) and migraine specific meds (Triptans and Ergot alkaloids) used to treat migraine pain and associated symptoms used at 1st sign of attack First-line treatment for migraine prevention? - Beta Blockers: Metoprolol or Propranolol First-line treatment for acute, mild to moderate migraine without nausea or vomiting? - NSAID: Naproxen or aspirin How to know someone would be appropriate for preventative migraine therapy? - Indicated for patients who have frequent attacks (3+ a month), severe attacks, or attacks that do not respond adequately to abortive therapy Opioid analgesic reserved for severe migraines that don't respond to first-line medications? - Butorphanol nasal spray; one spray each nostril every 60 minutes prn mechanism of action for sumatriptan: - suppresses the release of CGRP from trigeminal neurons