Case 2 Migraine Flashcards
A prodrome lasts ______ to _______
Few hours to days
How long does an aura typically last?
5 - 60 min
A headache lasts how long?
4 - 72 hrs
How long does a postdrome last?
24 - 48 hrs
What are the 4 phases of a migraine?
Prodrome, aura, headache, postdrome
These are characteristics of what phase of migraine?
Irritability, depression, yawning, increased need to urinate, food cravings, light/sound sensitivity, problems concentrating, fatigue and muscle stiffness, difficulty speaking and reading, nausea, difficulty sleeping?
Prodrome
These are characteristics of what phase of migraine?
Visual disturbances, loss of sight, numbness and tingling
Aura
These are characteristics of what phase of migraine?
Throbbing, drilling, icepick in head, N/V, giddiness, burning, insomnia, nasal congestion, anxiety, depression, sensitivity to light, smell, sound & neck pain/stiffness
Headache
These are characteristics of what phase of migraine?
Inability to concentrate, fatigue, depressed mood, euphoric mood, lack of comprehension
Postdrome
Name first line abortive migraine tx? (3)
- Acetaminophen
- ASA
- NSAIDs (advil, ibuprofen)
*bad on stomach/liver
Name 2nd line abortive migraine tx? (2)
- Triptans (avoided in pregnancy, heart failure, CVA, TIA hx or uncontrolled HTN)
- Ergots/ergotamine nasal spray (vasoconstrictor and shouldn’t be given to pt with CVA or pregnancy)
Name 3rd line abortive migraine tx? (3 and 1 we NEVER use)
Opioids- DO NOT USE!!!!!!
- Ketorolac injection
- Ergotamine IV
- Dexamethasone
This medication class ends in “olol” and are used for migraine prophylaxis?
B-blockers
*S/e digestive probs
This medication class ends in “ine/line” and are used for migraine prophylaxis?
- Anti-depressants
- SSRIs/SSNRIs (fluoxetine, venlafaxine)
- Tricyclic antidepressants (amitriptyline, nortriptyline)
Valproic acid & topiramate are what type of migraine med and used for abortive or prophylaxis?
Anti-convulsants
*s/e visual and speech probs
These anti-epileptics are used for migraine prophylaxis?
Gabapentin, Toprimate
*s/e visual and speech probs
Calcitonin Gene-Related Peptide Therapy are for abortive of prophylaxis and have what class ending?
prophylaxis, end in “umab”
What are two good supplements for migraine?
Mg and Vit D
Tension HA or migraine?
Generalized or bilateral Neck, traps, back of the head Steady pain Start later in the day N/V not common
Tension
Tension HA or migraine?
Unilateral Temporal Throbbing pain Any time N/V more common
Migraine
What type of HA requires O2 admin, can cause rhinorrhea or loss of vision on one side and is mc in men?
Cluster
Name a calcium channel blocker
Verapamil
