Pharmacotherapeutics Exam questions and 100% correct answers|latest 2025/2026

Pharmacotherapeutics Exam questions and 100%
correct answers|latest 2025/2026
Used to increase analgesic effect of pain relievers with HAs - ANSWER-Anti-
B B B B B B B B B B B


emetics: Promethazine (Phenergan); Prochlorperazine
B B B




(phenothiazine class; may cause sedation) B B B B




First line for TTH - ANSWER-Aspirin and Acetaminophen (no more than 2 days per week).
B B B B B B B B B B B B B B




Second line for TTH - ANSWER-
B B B B B


NSAIDs (antiemetic may be added). Also, caffeine containing OTC meds (Excedrin extra strength).
B B B B B B B B B B B B




Third line for TTH - ANSWER-Butalbital-containing compounds (Fioricet {butalbital-acetaminophen-
B B B B B B B B


caffeine} or Fiorinal). Never more than 3 days per month.
B B B B B B B B B




When to use prophylaxis treatment for TTH? What to use? - ANSWER-
B B B B B B B B B B B


More than 2 Tension type HAs per week.
B B B B B B B B




Amitriptylline (TCAs) B




Fluoxetine (SSRIs) B




Venlaxafine (SNRIs) B




Migraine treatment - Abortive agents - ANSWER-Serotonin 5-HT1D receptor agonists:
B B B B B B B B B




(Triptans: Sumatriptan, frovatriptan, naratriptan, rizatriptan,zolmitriptan, almotriptan, eletriptan)
B B B B B B




Serotonin 5-HT1B/1D receptor agonists
B B B




Eletriptan

Ergotamine derivatives B




Ergotamine tartrate, dihydroergotamine, isometheptene mucate
B B B B




Migraine prophylactic - ANSWER-Cyproheptadine
B B B




Migraines - Drug classes commonly used for prophylaxis - ANSWER-Analgesics
B B B B B B B B B




β-Blockers

Calcium channel blockers
B B

,Antidepressants

Anticonvulsants



Serotonin 5HT1 MOA - ANSWER-Cranial vessel constriction
B B B B B B




Inhibition of neuropeptide release
B B B




Reduced transmission in trigeminal pain pathways
B B B B B




ADE/Contraindications of Serotonin 5HT1 receptor agents: Triptans - B B B B B B B


BSUMATRIPTAN (Imitrex and Alsuma). Oznetra is intranasal spray. - ANSWER-
B B B B B B B B B


CX: pregnancy, uncontrolled HTN, IHD, TIA, stroke, PVD, hepatic impairment, basilar or hemiplegic mig
B B B B B B B B B B B B B


raine. Not used with MAOIs or as prophylactic treatment.
B B B B B B B B B




Use caution with other serotonergic drugs (SSRIs, SNRIs, other triptans)
B B B B B B B B B




DO NOT USE Ergot Derivatives with - ANSWER-
B B B B B B B


Potent CYP3A4 inhibitors, including protease inhibitors and macrolide antibiotics (severe vasospasm -
B B B B B B B B B B B


cerebral or extremity ischemia).
B B B B




Ergotamine derivatives - MOA - ANSWER- B B B B B


Partial agonist or antagonist activity against tryptaminergic, dopaminergic, or α-
B B B B B B B B B


adrenergic receptors, depending on binding site
B B B B B




Constrict peripheral and cranial blood vessels
B B B B B B




Depress central vasomotor centers
B B B




Decrease Extracranial blood flow
B B B B




B Decrease Hyperperfusion of the basilar artery area
B B B B B B




Ergotamine tartrate (Ergostat, Ergomar) - ANSWER-α-Adrenergic-blocking agent
B B B B B B




Direct stimulating effect on smooth muscle of peripheral and cranial vessels
B B B B B B B B B B




Stronger venoconstrictor and weaker arterial vasoconstrictor than ergotamine
B B B B B B B




Barbiturates MOA - ANSWER-(butalbital containing compounds such as Fioricet and Fiorinal)
B B B B B B B B B B

,Elicits generalized CNS depressant effects
B B B B




Depress sensory cortex B B




Decreases motor activity B B




Opioids: (Tylenol with Codeine) MOA - ANSWER-Narcotic agonist analgesic, mu receptor agonist
B B B B B B B B B B B




Use for severe migraines that don't respond to the above medications
B B B B B B B B B B




Steroids: (Dexamethasone) MOA - ANSWER- B B B B


Controls or prevent inflammation by controlling rate of protein synthesis.
B B B B B B B B B




Use in patients with severe/persistent HA, short-term.
B B B B B B




Anti-emetics: (Prochlorperazine) MOA - ANSWER- B B B B


They enhance analgesic activity of the other agents (Prochlorperazine suppository).
B B B B B B B B B




Blocks vagus nerve in GI tract
B B B B B




First line for migraines - ANSWER-
B B B B B


ASA & NSAIDs are the first step in the acute Tx of mild to moderate migraine that is not associated wit
B B B B B B B B B B B B B B B B B B B B


h N&V.
B




Triptans are first line for moderate to severe migraine with or w/o an anti-emetic.
B B B B B B B B B B B B B




NSAIDs may be tried for more severe headaches (but may not work)
B B B B B B B B B B B




Second line for migraines - ANSWER-
B B B B B


OTC caffeine containing products (like Excedrin) for mild to moderate HA that have not responded to 1
B B B B B B B B B B B B B B B B


st line agents.
B B




For more severe HAs an ergot derivative with an anti-emetic
B B B B B B B B B




Third line for migraines - ANSWER-If the above agents are ineffective, triptans should be tried.
B B B B B B B B B B B B B B




For more severe HAs that have not responded to triptans or ergot derivatives and antiemetics, butalbi
B B B B B B B B B B B B B B B


tal-containing compounds or opioids may be used. B B B B B B

, Midrange analgesics: combination products like butalbital with ASA or APAP (Fioricet) or isomethhept
B B B B B B B B B B B B


ene with APAP and dichloral phenazone (Midrin)
B B B B B B




High-
range anagesics: commonly used opioids: APAP #3, meperidine (Demerol), butorphanol (Stadol), oxyc
B B B B B B B B B B B


odone, hydrocodone
B




Migraine prophylactic agents - ANSWER-β-Blockers
B B B B B




Stabilize vascular toneB B




Propranolol, metoprolol, atenolol, timolol B B B




Calcium channel blockers
B B




Regulate vascular smooth muscle contraction, neurotransmission, and hormone secretion enzyme act
B B B B B B B B B B


ivity

Verpamil B




Tricyclic antidepressants
B




Increase availability of synaptic norepinephrine
B B B B




Serotonin "downregulation" of 5-HT receptors and β-receptor activity
B B B B B B B




Amitryptilline, nortryptilline, imipramine B B




Selective serotonin receptor inhibitors (SSRI)
B B B B B




Potent-specific 5-HT receptor reuptake inhibitors B B B B




Reduce frequency and intensity
B B B




Prevent venoconstrictive effect of decreased serotonin levels during headache
B B B B B B B B




Venlaxafine and fluoxetine B B




Anticonvulsants

Influence on cerebral arteries and circadian rhythms
B B B B B B




May help regulate secretion of hormones
B B B B B




Gabapentin and topiramate` B B