Chapter 51 - Migraines and Other Headaches

Question 1

naproxen sodium (Aleve)

Answer 1

Class: NSAIDs

Question 2

naproxen sodium (Aleve)
MOA:
Use:
AE:
BBW:

Answer 2

MOA: Nonselective COX-1 and COX-2 inhibitor
Use: Reduce pain resulting from an acute migraine
AE: Bronchospasm and anaphylaxis
BBW: May put patients at increased risk for cardiovascular events and GI bleeding

Question 3

acetaminophen

MOA:

Answer 3

MOA: Analgesic

Question 4

Aspirin

MOA:

Answer 4

MOA: Inhibits synthesis of prostaglandins (inflammatory process)

Question 5

Caffeine

MOA:

Answer 5

MOA: Causes vasoconstriction, increases effect of aspirin in Tylenol by about 40% (synergistic effect) –> drink with coffee, decreases pain of headache

Question 6

ergotamine tartrate (Ergomar)

Answer 6

Class: Ergot Alkaloids

Question 7

ergotamine tartrate (Ergomar)
MOA:
Use:
Admin:
AE:
Contra:

Answer 7

MOA: Constricts cranial and peripheral blood vessels
Use: Migraines
Admin: Sublingual, IM, subQ, IV, nasal spray
AE: Bradycardia, edema, dysrhythmias, chest pain, tachycardia, vasospasms, numbness, weakness, vertigo
Contra: Patients w/ history of cardiac problems (dysrhythmias, peripheral vascular disease), coronary artery disease, hepatic/renal disease, hypertension, patients who are septic (bloodstream infection), pregnancy category X (fetal harm/death)

Question 8

sumatriptan (Imitrex)

Answer 8

Class: Triptans

Question 9

sumatriptan (Imitrex)
MOA: 
Use:
Admin:
AE:
Contra:
Caution:

Answer 9

MOA: Binds to the serotonin receptors 5-HT1D, producing vascular construction of the cranial blood vessels and relieving the pain of a migraine headache
Use: Migraines, cluster headaches
Admin: Administered at onset of migraine (when start feeling pain/aura), nasal spray, PO, subQ injection, must be monitoring BP b/c of hypertension, patient teaching about med
AE: Hypertension, dizziness, chest pain, nasal spray can cause drainage down throat and really bad taste, throat irritation –> can make patients sick to stomach; injection can cause soreness at site
BBW: Cardiovascular warning - increases risk of thrombolic events..MI, CVA, stroke
Caution: If patient has had ergo alkaloids..CANNOT HAVE TRIPTAN DRUG WITHIN 24 HOURS!

Question 10

Estradiol
MOA:
Use:
Cautions:

Answer 10

MOA: Prophylactic administration minimizes the premenstrual decline in estrogen that precipitates the development of the migraine headache
Use: Treatment of menstrual migraines
Cautions: Increases risk of neoplasm (breast cancer) and can increase risk of thromboembolic disorder –> benefits must be greater than risk in patient! ; Pregnancy category X

Question 11

• Carboxylic acid derivative
• Gamma-aminobutyric acid
• Sulfamate-substituted monosaccharide
• Beta-andrenergic blocking agents - beta blockers; most common - heart disease, blood pressure (HTN)

Answer 11

Preventative Therapy for Migraine Headaches

Question 12

• Calcium channel blockers
• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin II receptor blockers
• Tricyclic antidepressants
• Herbal supplements

Answer 12

Preventative Therapy for Migraine Headaches

Question 13

Adjuvant: Antimetics

Answer 13

Help to control N/V..vomiting can increase intracranial pressure, which can worsen headache/migraine

Question 14

Adjuvant: Benzodiazepines

Answer 14

Can be used to relax patients

Question 15

Adjuvant: Opioid analgesics

Answer 15

May be given (not primary treatment/recommended treatment), but usually combination meds, for headache