Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Natural Products > 17 - Migraines > Flashcards

17 - Migraines Flashcards

1
Q

Higher prevalence among ______

A

females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

_____ predisposition to migraines

A

genetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List 3 migraine triggers (more on slide 4)

A
  • emotional stress
  • smoke
  • not eating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe a typical migraine headache

A
  • Unilarteral (most often) - but not always on the same side
  • Throbbing, pulsating (recall the trigeminal influence on the arteries of the dura
  • Attack progressively worsens over hours
  • Often N & V (vomiting less common)
  • Photophobia/Phonophobia very common (sensitive to light and sounds) - often migraine sufferer will need to rest in dark, quiet room because of this
  • Osmophobia and cutaneous allodynia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some red flag symptoms?

A
  • Age > 50
  • severe and abrupt onset
  • worsening over days/weeks
  • stiff neck, focal signs, reduced consciousness
  • abnormal speech, motor reflex, cognitive impairment
  • fever, rash, n,v
  • new onset of cancer, lyme disease or HIV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some differential diagnoses for migraines?

A
  • Mass/lesion, CVE, meningitis
  • Hemorrhage
  • Subdural hematoma
  • Encephalitis, meningitis
  • Metastasis, opportunistic infection, etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is acute drug treatment?

A

Abortive medications “relievers”

-Taken prn for headache symptom relief (ex. sumatriptan, ibuprofen, ergotamine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is preventative drug treatment?

A

aim to decrease migraine frequency, taken on a regular basis (ex. amitriptyline, topiramate, metoprolol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When do you consider migraine prophylaxis?

A
  • Frequent and/or long-lasting and/or severely debilitating migraines
  • CI to acute therapies
  • Failure of acute therapy (either poor efficacy &/or intolerable SEs)
  • > 2 attacks per week (risk of MOH) - medication overuse headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Goals of migraine prophylaxis

A

reduce attack frequency by > 50% and severity, reduce associated disability, prevent transition from acute > chronic migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List 5 NHPs for migraine

A
  • butterbur
  • feverfew
  • riboflavin
  • coenzyme Q10
  • magnesium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Butterbur:

Scientific name of butterbur

A

Petasites hybridius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Butterbur:

Lots of extracts of butterbur have been used, but in migraine the ______ extract has been primarily evaluated

A

rhizome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Butterbur:

Is butterbur for prevention or treatment of migraines?

A

prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Butterbur:

List a few other things that people use butterbur for

A

pain, stomach upset, gastric ulcers, headache, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Butterbur:

What is butterbur most possibly effective for?

A

migraines, allergic rhinitis and somatoform disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Butterbur:

Dosage for migraine management of butterbur?

A

migraine prophylaxis in adults: 50-75 mg BID for 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Butterbur:

Safe?

A

possibly safe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Butterbur:

Butterbur products should be labeled “PA Free” which means what?

A

They are free of pyrrolizidine alkaloids, which is a hepatotoxic agent. Repeated use can cause veno-occlusive disease, can be carcinogenic.. effects can be systemic if used on broken skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Butterbur:

Can butterbur be used in pregnancy or lactation?

A

likely unsafe

-may be teratogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Butterbur:

Adverse effects ?

A

GI symptoms, including nausea, flatulence and belching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Butterbur:

Is it deemed effective ?

A

yes - for migraine prevention

“possibly effective”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Butterbur:

What does turcotte think after reviewing the evidence?

A
  • seems to reduce frequency of migraines when used over a period of 16 weeks in adults
  • can reduce frequency, intensity and duration of migraines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Butterbur:

What does it interact with?

A

CYP 3A4 if it contains the hepatic pyrrolizidine alkaloid and could cause even more hepatotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Butterbur:

What are potential cross allergies ?

A

Asteraceaea/ composite family - ragweed, chrysanthemums, marigolds, daisies and other herbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Butterbur:

Due to potential “PA” contamination, patients with _____ dysfunction may want to avoid butterbur

A

liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Butterbur:

MOA of anti-inflammatory action of butterbur ?

A

might have an effect by inhibiting leukotriene synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Butterbur:

MOA of smooth muscle relaxant/VD effect ?

A

anti-spasm effects of smooth muscle and vascular wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Butterbur:

Should we recommend ?

A

Yes as long as no significant interactions and they are monitoring for adverse effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Scientific name of CoEnzyme Q10 ?

A

Mitoquinone Ubidecarenone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

CoEnzyme Q10:

Produced _____ in the body and plays multiple vital roles

A

endogenously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

CoEnzyme Q10:

Levels decline with ?

A

age and chronic illnesses including CV disease, muscular dystrophies, parkinson’s, cancers, diabetes, HIV/AIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

CoEnzyme Q10:

For prevention or treatment of migraines

A

prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

CoEnzyme Q10:

What has been shown to deplete body stores ?

A

smoking cigarettes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

CoEnzyme Q10:

What do people use it for?

A

migraines, male fertility, neurological disorders, diabetes, Prader-Willi syndrome, CV disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

CoEnzyme Q10:

Dose?

A

300mg daily split up in 100mg TID

(A dose of 1200 mg/day) showed promise in patients with end-stage renal disease at high cardiac risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

CoEnzyme Q10:

Safe ?

A

Likely lmao

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

CoEnzyme Q10:

What does Canadian headache society say?

A

strong recommended based on low quality evidence for migraine prophylaxis

39
Q

CoEnzyme Q10:

What does American headache society say?

A

Level C recommendation - possibly effective, ineffective or harmful

40
Q

CoEnzyme Q10:

What does European Federation of Neurological Societies say ?

A

Level C recommendation - possibly effective, ineffective or harmful

41
Q

CoEnzyme Q10:

Side effects?

A

stomach upset, loss of appetite, nausea, vomiting and diarrhea

42
Q

CoEnzyme Q10:

Effective ?

A

possibly

43
Q

CoEnzyme Q10:

Important drug interactions ?

A

Warfarin, decreases BP, might lower effectiveness of doxorubicin

Statins lower CoQ10 levels

44
Q

CoEnzyme Q10:

How does it effect BP ?

A

thought to lower BP (interacts with antihypertensives)

45
Q

CoEnzyme Q10:

Safe in pregnancy or lactation ?

A

evidence is lacking

46
Q

CoEnzyme Q10:

What is the MOA ?

A

CoQ10 is the cofactor in the electron transport chain and protects against mitochondrial collapse/degradation during respiratory chain - involved in oxygenated ATP production

Low CoQ10 associated with mitochondrial dysfunction in occipital lobes of patients with migraines

Theory is to supplement the CoQ10 deficiency

47
Q

Feverfew:

Scientific name ?

A

Tanacetum parthenium

48
Q

Feverfew:

The leaves of the plant are generally _____ prior to being used medicinally, though fresh leaf extract is also used.

A

dried

49
Q

Feverfew:

Prevention or treatment of migraines?

A

prevention

50
Q

Feverfew:

What do people use it for?

A

Oral: fever, headaches, menstrual irregularities, arthritis, psoriasis, allergies

Topical: insecticide and tooth ache reliever

51
Q

Feverfew:

Standardized to _____ content

A

Parthenolide

52
Q

Feverfew:

Standardization of parthenolide in clinical trials ranges from which percentages?

A
  1. 2% - 0.35%

* impact of standardization on efficacy is not clear

53
Q

Feverfew:

Dose ?

A

5-15 mg PO of feverfew powder once daily

54
Q

Feverfew:

Describe the making of a feverfew tincture

A

2.5 fresh leaves with or after food and the tincture can be used in 5-10 drops of 1:5 parts, 25% ethanol tincture

55
Q

Feverfew:

Need to taper ?

A

Yes - to avoid withdrawal symptoms

56
Q

Feverfew:

Been used in combo with ?

A

white willow or ginger

57
Q

Feverfew:

Safe ?

A

Likely safe for short term basis, studies have only been done for 4 months of use

58
Q

Feverfew:

Should we advise people to chew raw (unprocessed, fresh) feverfew leaves?

A

No - can lead to adverse effects such as oral inflammation, ulceration, swelling of the lips and sometimes loss of taste

59
Q

Feverfew:

Why should it be avoided in pregnancy?

A

Documented adverse effects (emmenagogue - ejection of placenta and fetal membranes)

Includes uterine contraction

60
Q

Feverfew:

When is feverfew safe ?

A

safe when used orally and appropriately short-term

61
Q

Feverfew:

Side effects ?

A

Fairly well-tolerated

-contact dermatitis, GI upset, potential CNS allergic reaction

62
Q

Feverfew:

Effective ?

A

Possibly

63
Q

Feverfew:

Helps to decrease ____ of headaches

A

frequency

64
Q

Feverfew:

Important drug interactions?

A

NSAIDs, anti-platelets, anti-coagulants, salicylates and any natural products that affect coagulation

Multiple CYP interactions (3A4, 2C9, 2C19)

65
Q

Feverfew:

Cross allergies ?

A

similar to chrysanthemums, chamomile, sunflowers and ragweed

66
Q

Feverfew:

May ____ platelet aggregation and should therefore be avoided in individuals with clotting disorders.

A

inhibit

67
Q

Feverfew:

MOA

A

cox - 2 inhibitor, inhibits myocardial angiogenesis and inhibits platelet aggregation

parthenolide acts as a partial agonist of TRPAI, which can cause migraines.

68
Q

Feverfew:

Should we recommend ?

A

No - lots of side effects and drug interactions and efficacy not proven !!

69
Q

Magnesium:

What contributes to deficiency?

A

low dietary intake and impaired absorption

70
Q

Magnesium:

Prevention or treatment

A

both

71
Q

Magnesium:

Deficiency can be linked to various health conditions such as ?

A

osteoporosis, hypertension, atherosclerotic vascular disease cardiomyopathy, diabetes and stroke

72
Q

Magnesium:

What is it found in?

A

legumes, whole grains, veggies, seeds & nuts, hard water

73
Q

Magnesium:

RDA for female adults

A

310 mg/day

74
Q

Magnesium:

RDA for male adults

A

400 mg/day

75
Q

Magnesium:

Safe?

A

likely safe

76
Q

Magnesium:

Effective?

A
  • insufficient reliable evidence to rate

- “possibly effective” is not extremely compelling

77
Q

Magnesium:

Side effects?

A

Oral Mg: loose stool and diarrhea, N, V, GI irritation

IV Mg: flushing sensation, local pain and irritation, dizziness, bradycardia and hypotension

78
Q

Magnesium:

Aside for pentamidine, what are three drugs that can cause MAJOR depletion, often requiring supplementation

A

ampho B, tacrolimus, PPIs

79
Q

Magnesium:

Normal serum Mg levels ?

A

0.65 - 1.05 mmol/L

80
Q

Magnesium:

Caution in those with ?

A

reduced kidney function due to an increased risk of hypermagnesemia

81
Q

Magnesium:

What can hypermagnesemia cause?

A

can cause heart block

IV formulations are CI in heart block, bleeding disorders (magnesium increases bleeding risk)

82
Q

Magnesium:

MOA

A
  • magnesium is a co-factor in enzymatic reactions in body involving protein synthesis and carb metabolism
  • suggested that magnesium plays a central role in establishing a threshold for migraine attacks
83
Q

Magnesium:

Do we recommend it?

A

Nah - not effective

84
Q

Riboflavin:

What is it?

A

water-soluble B vitamin known as vitamin B2

85
Q

Riboflavin:

Used for prevention or treatment?

A

prevention

86
Q

Riboflavin:

What is it found in?

A

liver, kidneys, dairy products, green vegetables, eggs, whole grain cereals, yeast and shrooms

87
Q

Riboflavin:

dosage for migraine prophylaxis?

A

400mg/day for up to 3 months

88
Q

Riboflavin:

What are 2 PK/PD properties of riboflavin in the body that are thought to limit any potential toxicity include ?

A

1) limited absorption into the blood stream due to increased GI motility (only 27mg of the 400mg dose would be maximally absorbed)
2) excretion in the urine

89
Q

Riboflavin:

safe?

A

likely

90
Q

Riboflavin:

In the US, it is labelled as GRAS , which stands for ?

A

generally recognized as safe

91
Q

Riboflavin:

Can change _____ color

A

urine

bright yellow orange

92
Q

Riboflavin:

Adverse effects

A
  • weight gain
  • dizziness
  • GI discomfort
93
Q

Riboflavin:

effective ?

A

possibly effective

94
Q

Riboflavin:

drug interactions?

A

if you are on oral contraceptives, it will decrease concentrations of riboflavin

Natural Products (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions