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Neuro weeks4-6 - Keith > 30 - Headache Therapy > Flashcards

30 - Headache Therapy Flashcards

1
Q

MOA of nabumetone

A

NSAID. Reduce inflammatory stimuli that would normally upregulate MAPK and thus CGRP and SP. More effective if taken sooner than later.

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2
Q

MOA of ibuprofen

A

NSAID. Reduce inflammatory stimuli that would normally upregulate MAPK and thus CGRP and SP. More effective if taken sooner than later.

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3
Q

MOA of naproxen

A

NSAID. Reduce inflammatory stimuli that would normally upregulate MAPK and thus CGRP and SP. More effective if taken sooner than later.

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4
Q

MOA of butalbital

A

barbiturate. Has sedative-hypnotic effects via thalamic GABA enhancement.

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5
Q

ADE of butalbital

A

drowsiness, sedation, strongly linked to analgesic overuse syndrome, CYP inducer, respiratory depressant

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6
Q

MOA of caffeine for headaches

A

cerebral vasoconstriction. Useful for caffeine withdrawal headaches. mixed with NSAIDs and butalbital sometimes

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7
Q

ADE of caffeine for headaches

A

potential CV interactions

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8
Q

MOA of sumatriptan

A

triptan. Serotonin agonist with only central effects. Causes carotid vasoconstriction via 5-HT1-B.
Presynaptic inhibition of trigeminovascular system via 5-HT1d/f.

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9
Q

MOA of ergotamine

A

contraction of smooth muscle fibers of small arteries.

agonist of central 5-HT, peripheral alpha vasoconstrictor, and decreases amine reuptake.

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10
Q

MOA of dihydroergotamine

A

contraction of smooth muscle fibers of small arteries.

agonist of central 5-HT, peripheral alpha vasoconstrictor, and decreases amine reuptake.

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11
Q

What is fastest and most effective for migraine treatment?

A

subcu injection of sumatriptan

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12
Q

What drug is strongly linked to analgesic-overuse syndrome?

A

butabital

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13
Q

Which triptans have longest effect time?

A

narotriptan and frovatriptan

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14
Q

ADE of triptans?

A

dizziness, drowsy, fatigue, tightness of chest, coronary and peripheral vasospasm, serotonin syndrome with SSRIs.
Contraind in heart disease or uncontrol HTN and ishcemic bowel.

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15
Q

ADE of ergots?

A

interactions with B-blockers and DA. Contraindicated in vasospastic conditions.
large doses cause st anthony’s fire –> dry gangrene of extremeties

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16
Q

What migraine medicines can be given to preggers?

A

NSAIDs only

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17
Q

What drugs should be given for menstrual headaches?

A

NSAIDs only

18
Q

MOA of metoclopramide

A

antiemetic. D2 central block, increase Ach

19
Q

ADE of metoclopramide

A

risk of high prolactin and gynecomastia

20
Q

MOA of prochlorperazine

A

antiemetic. D2 central block. cholinergic and alpha block

21
Q

ADE of prochlorperazine

A

dyskinesia, hypotension, gluacoma, urine reten, BPH

22
Q

MOA of promethazine

A

antiemetic. cholinergic block and H1 (weak D2)

23
Q

ADE of promethazine

A

glaucoma, urine reten, BPH, drowsy, parkinson

24
Q

MOA of chlorpromazine

A

antiemetic. D2 central block, cholinergic and alpha block.

25
Q

ADE of chlorpromazine

A

dyskinesia, hypotension, glaucoma, urine reten, BPH

26
Q

MOA of amitriptyline

A

decrease NE and serotonin reuptake. Strong anticholinergic

27
Q

ADE of amitriptyline

A

agressiveness, weight gain, dry mouth, sedation

28
Q

What is only drug approved for migraine prophylaxis in children?

A

propranolol

29
Q

ADE of propranolol

A

fatigue, exercise, intolerance, asthma, diabetes, AV block

30
Q

ADE of propranolol

A

fatigue, exercise, intolerance, asthma, diabetes, AV block

31
Q

MOA of topiramate

A

Na and glutamate blocker, increases GABA

32
Q

What migraine drug would likely interact with MAO inhibitors like phenelzine?

A

suamtriptan. Cant give within 2 weeks of MAOI treatment.

33
Q

ADE of topriamate

A

paresthesis, fatigue, nausea, narrow therapeutic range

34
Q

What are alternative treatments for migraine prevention?

A

ferverfew and butterbur but don’t use them in preggers

35
Q

Can you take a triptan after taking an ergot?

A

no. wait at least 24 hours.

36
Q

Can you use triptans in preggers?

A

yes. but not in heart disease, diabetes, uncontrolled HTN or cerebrovascular disease.

37
Q

MOA of timolol

A

nonselective beta antagonist. 5-10x more potent than propanolol. Arterial constrictor so reduces NE-induced lipolysis

38
Q

ADE of timolol

A

fatigue, exercise, intolerance, asthma, diabetes, AV block

39
Q

MOA of eletriptan

A

triptan. reduce blood vessel swelling. 5HT-1b/d/f receptor agonist.

40
Q

ADE of eletriptan

A

HTN, tachycardia, headache, dizzyness, chest pain.
contraindicated in cardiovascular disease or renal/hepatic impairment
requires CYP3A4 so dont’ give with CYP inhibitors.

41
Q

MOA of valproate

A

anticonvulsant. Weak Na blocker, weak GABA transaminase inhibitor (so blocks GABA degredation)

42
Q

ADE of valproate

A

don’t give in pregnancy.

tiredness, tremor, sedation, GI disturb, hair loss.

Neuro weeks4-6 - Keith (37 decks)

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