Ch 30: Drugs for Headache Flashcards
What is hyperalgesia?
an augmented response to painful stimuli
p. 305
What is allodynia?
a painful response to normally innocuous stimuli
p. 305
How long do most migraines last?
4 to 72 hours with a median duration of 24 hours
p. 305
What is a migraine headache?
A neurovascular disorder that involves dilation and inflammation of intracranial blood vessels.
(p. 305)
What 2 compounds play important roles in migraines?
How so?
calcitonin gene-related peptide (CGRP) and serotonin (5-hydroxytryptamine, a.k.a. 5HT)
CGRP promotes migraine, and serotonin suppresses migraine
(p. 306)
Drugs for migraine are employed in what 2 ways?
To abort an ongoing attack, or to prevent attacks.
p. 306
What kind of drugs exist which help abort an attack?
non-specific analgesics (aspirin-like drugs, opioids)
migraine-specific drugs [serotonin 1B/1D receptor agonists (i.e. the triptans), and ergot alkaloids
(p. 306)
What drugs exist for migraine prophylaxis?
beta blockers, tricyclic antidepressants, and antiepileptic drugs
(p. 306)
In people with migraine, the brain seems to have…
…a low tolerance for the ups and downs of life.
p. 306
What GI disturbances do migraines cause?
nausea, vomiting, gastric stasis
p. 306
Use of abortive medications should be…
…limited to 1 - 2 days a week, d/t the risk of medication overuse headache.
(p. 306)
What 2 antiemetics are recommended for use in patients with migraines?
metoclopramide & prochlorperazine
p. 306
Which drugs are included in the “aspirin-like drugs” category?
aspirin, acetaminophen, naproxen, diclofenac, etc.
p. 306
For mild to moderate migraines, aspirin combined with…
…metoclopramide to enhance absorption, may work as well as sumatriptan.
(p. 307)
Clinical pearl: what are some brand names for combination drugs containing butalbital, acetaminophen, and caffeine?
Fioricet, Esgic, Capacet, Margesic, Phrenilin Forte, Zebutal
[From Lexicomp]
