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Pharm U3 > 12) Headaches > Flashcards

12) Headaches Flashcards

1
Q

What is the mechanism for Analgesics

A

Inhibition of COX (COX2 may be preferential)

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2
Q

What are the therapeutics for Analgesics

A

Acute treatment of moderate migraine (combination of acetaminophen, aspirin, and caffeine); acute treatment of tension headaches

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3
Q

What are the therapeutics for Barbiturates

A

Acute treatment of migraines; use when more traditional therapies unavailable or contraindicated

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4
Q

What are the important side effects for Barbiturates

A

Drowsiness, dizziness

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5
Q

What are the miscellaneous for Barbiturates

A

Use limited to 2-3 times per week

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6
Q

What are the therapeutics for Opioids

A

Acute treatment of migraines; patients with infrequent headaches; generally, for patients who wake up with a headache

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7
Q

What are the miscellaneous for Opioids

A

Use less than 2 days per week; pregnant women may use codeine or meperidine with caution

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8
Q

What are the therapeutics for Corticosteroids

A

Acute treatment of migraines; migraine, prolonged headache syndromes (e.g., chronic daily headache); rescue treatment of cluster headache

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9
Q

What are the miscellaneous for Corticosteroids

A

Chronic medicaton/overuse most common cause of chronic daily headaches

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10
Q

What is the mechanism for Ergotamines

A

Vasoconstriction possibly; may also act as a 5HT agonist in trigeminovascular pathway

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11
Q

What are the therapeutics for Ergotamines

A

Acute treatment of migraines

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12
Q

What are the important side effects for Ergotamines

A

Nausea, dizziness, paresthesia, chest pain, abdominal cramps

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13
Q

What are the miscellaneous for Ergotamines

A

Contraindicated in women planning pregnancy, uncontrolled HTN, sepsis, renal or hepatic failure, vascular disease

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14
Q

What is the mechanism for DHE (Migranal)

A

Vasoconstriction possible; mainly act as a 5HT agonist in trigeminovascular pathway

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15
Q

What are the therapeutics for DHE (Migranal)

A

Acute treatment of migraines; less likely to cause rebound headache than ergotamines; acute treatment of cluster headaches; short-term prevention of cluster headaches (along with steroids)

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16
Q

What are the important side effects for DHE (Migranal)

A

Nausea (less likely than ergotamines), dizziness, paresthesia, chest pain, abdominal cramps

17
Q

What are the miscellaneous for DHE (Migranal)

A

Contraindicated in women planning pregnancy, uncontrolled HTN, sepsis, renal or hepatic failure, vascular disease; injectable

18
Q

What is the class for Sumatriptan (Imitrex)

A

Triptans

19
Q

What is the mechanism for Sumatriptan (Imitrex)

A

Selective 5HT1b-d agonists; penetration of CNS, constriction of extracerebral intracranial vessels, inhibition of trigeminovascular system

20
Q

What are the therapeutics for Sumatriptan (Imitrex)

A

Acute treatment of migraines (premier option); also effective for photo/phonophobia, nausea and vomiting; acute treatment of cluster headaches

21
Q

What are the important side effects for Sumatriptan (Imitrex)

A

Flushing, tingling, dizziness, chest discomfort (noncardiac)

22
Q

What are the miscellaneous for Sumatriptan (Imitrex)

A

Contraindicated in vascular disease (including Prinzmetal), uncontrolled HTN, complicated migraine; injectable (suma)

23
Q

What is the mechanism for Onabotulinum toxin (Botox)

A

Unknown (possibly decreased afferent stimulation of trigeminovascular system, or downregulation of sensory and parasympathetic receptors)

24
Q

What are the therapeutics for Onabotulinum toxin (Botox)

A

Acute treatment of chronic migraine headaches

25
Q

What are the other side effects for Onabotulinum toxin (Botox)

A

Injection site pain, headache, neck weakness, ptosis

26
Q

What are the therapeutics for TCA

A

Migraine prevention, tension headache prevention

27
Q

What are the important side effects for TCA

A

Dry mouth, constipation, weight gain, cardiac toxicity, orthostatic hypotension

28
Q

What are the miscellaneous for TCA

A

Amitriptyline, protriptyline, nortriptyline

29
Q

What are the therapeutics for SSRIs

A

Migraine prevention, tension headache prevention

30
Q

What are the important side effects for SSRIs

A

Weight gain, sexual dysfunction, headache

31
Q

What are the miscellaneous for SSRIs

A

Fluoxetine, paroxetine, sertraline

32
Q

What are the therapeutics for Beta-blockers

A

Migraine prevention (only propranolol and timolol FDA approved)

33
Q

What are the important side effects for Beta-blockers

A

Drowsiness, depression, decreased libido, hypotension, memory disturbance

34
Q

What are the miscellaneous for Beta-blockers

A

Propranolol, timolol, nadolol, atenolol; contraindicated in asthma, diabetes, CHF, or Raynaud’s

35
Q

What are the therapeutics for Calcium Channel Blockers

A

Migraine prevention; particularly useful in prolonged or disabling aura, or complicated migraine syndromes (e.g., hemiplegic migarine); long-term prevention of cluster headaches

36
Q

What are the important side effects for Calcium Channel Blockers

A

Constipation, dizziness

37
Q

What are the miscellaneous for Calcium Channel Blockers

A

Verapamil most commonly used

38
Q

What are the therapeutics for Oxygen

A

Acute treatment of cluster headaches

39
Q

What are the miscellaneous for Oxygen

A

Rebound can occur when oxygen stopped

Pharm U3 (13 decks)

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