DSA 5: Drugs for HA

Question 1

What are the tx options for an acute tension HA?

Answer 1

1. NSAID alone
2. NSAID + caffeine
3. NSAID + barbiturate
4. NSAID + caffeine + barbiturate

Question 2

True or False: Overuse of NSAIDs can provoke HA?

Answer 2

True

Question 3

Things to know about NSAIDs (4)

Answer 3

1. inhibit prostaglandin synthesis
2. effective against mild to moderate pain
3. cause gastric irritation and GI bleeding, nephrotoxicity has been observed
4. They have a black box warning concerning cardiac event

Question 4

Butalbital is a member of what family?

Answer 4

sedative-hypnotic family, it is a barbiturate

Question 5

What is the mechanism of Butalbital?

Answer 5

facilitation of GABA NT

Question 6

What substance is contraindicated with Butalbital?

Answer 6

alcohol, this drug has significant interactions with other sedative hypnotics

Question 7

What might contribute to rebound HA with Butalbital?

Answer 7

withdrawal with overuse

Question 8

What is the MOA for Caffeine?

Answer 8

competitive antagonist at adenosine receptors

Question 9

What 2 problems typically occur with pt taking caffeine?

Answer 9

1. high doses cause anxiety and palpitations

2. termination in pt who are dependent provokes HA

Question 10

What drugs are used as a prophylactic tx for tension HA?

Answer 10

Older antidepressants (NOT SSRIs) 
ex. Amitriptyline, Doxepin, Imipramine