FINAL EXAM NR566 STUDY GUIDE WITH
VERIFIED QUESTIONS AND RATIONALES 2026
◉ Phenytoin and contraceptive interaction Answer: Makes OC's less
effective, should have backup or increase dose.
◉ How is phenytoin effectiveness monitored? Answer: Serum drug
level.
Absence of seizures during trial drug period.
◉ What anticonvulsant would be given for adjunctive therapy for
partial seizures with or without secondary generalization? Answer:
Lamotrigine
◉ What medication (with example) can be used preventatively for
migraines? Answer: Beta blockers such as metoprolol/propranolol
◉ What is abortive therapy? Answer: Abortive therapy is aimed at
alleviating pain during the aura phase (if present) or soon after the
headache has started.
◉ What are examples of abortive therapy for migraines? Answer:
NSAIDS, opioids, triptans, ergot alkaloids
, ◉ What is the first line treatment for acute mid/moderate migraines
without vomiting? Answer: NSAIDs such as naproxen or ASA
◉ When is it appropriate to prescribe a patient preventative therapy
for migraines? Answer: Frequent attacks 3 or more a month, or
attacks that do not respond to abortive therapy, severe migraines.
◉ What are examples of opioid analgesics for severe migraines?
Answer: Butorphanol nasal spray. Spray each nostril Q60 min PRN
◉ What is the mechanism of action for sumatriptan? Answer:
Suppresses release of CGRP from trigeminal neurons.
This leads to vasoconstriction and decreased perivascular
inflammation to relieve migraine pain.
◉ The first dose of triptan should be under medical supervision for
what reason? Answer: In the case of any unknown underlying
cardiac condition.
◉ What are contraindications to triptans? Answer: Ischemic heart
disease
HTN
CV disease
VERIFIED QUESTIONS AND RATIONALES 2026
◉ Phenytoin and contraceptive interaction Answer: Makes OC's less
effective, should have backup or increase dose.
◉ How is phenytoin effectiveness monitored? Answer: Serum drug
level.
Absence of seizures during trial drug period.
◉ What anticonvulsant would be given for adjunctive therapy for
partial seizures with or without secondary generalization? Answer:
Lamotrigine
◉ What medication (with example) can be used preventatively for
migraines? Answer: Beta blockers such as metoprolol/propranolol
◉ What is abortive therapy? Answer: Abortive therapy is aimed at
alleviating pain during the aura phase (if present) or soon after the
headache has started.
◉ What are examples of abortive therapy for migraines? Answer:
NSAIDS, opioids, triptans, ergot alkaloids
, ◉ What is the first line treatment for acute mid/moderate migraines
without vomiting? Answer: NSAIDs such as naproxen or ASA
◉ When is it appropriate to prescribe a patient preventative therapy
for migraines? Answer: Frequent attacks 3 or more a month, or
attacks that do not respond to abortive therapy, severe migraines.
◉ What are examples of opioid analgesics for severe migraines?
Answer: Butorphanol nasal spray. Spray each nostril Q60 min PRN
◉ What is the mechanism of action for sumatriptan? Answer:
Suppresses release of CGRP from trigeminal neurons.
This leads to vasoconstriction and decreased perivascular
inflammation to relieve migraine pain.
◉ The first dose of triptan should be under medical supervision for
what reason? Answer: In the case of any unknown underlying
cardiac condition.
◉ What are contraindications to triptans? Answer: Ischemic heart
disease
HTN
CV disease
