Exam 1: Chapter 16&13: Headaches

Question 1

There are 4 types of headaches. What are they?

Answer 1

1. Cluster headaches
2. Tension headaches
3. Migraine headaches
4. Sinus headaches

Question 2

Cluster headaches occurs in

Answer 2

Occurs in clusters (min to hrs) for a period of days followed by a long period of spontaneous remission.

Question 3

Cluster headaches usually occur in

Answer 3

Men between 20-50 years old

Question 4

Cluster Headaches are caused by

Answer 4

Trigeminal activation and autonomic dysfunction

Question 5

Cluster headaches symptoms

Answer 5

UNILATERAL trigeminal distribution of severe pain with ipsilateral autonomic manifestations (tearing on affected side; ptosis of the ipsilateral eye; stuffy nose)

Question 6

Tension Headaches

Answer 6

Most common

Average onset 2nd decade

Question 7

Tension Headache symptoms

Answer 7

Mild to moderate BILATERAL headache with a sensation of a tight band or pressure around the head with gradual onset of pain.

Question 8

Tension Headaches occur

Answer 8

In episodes and may last for several hours or days.

Occurs at least 15 days per month for at least 3 months

Question 9

Migraines

Answer 9

Common type of recurring headache, usually lasting from 4-72 hours.

Question 10

Migraines: Typical Features

Answer 10

Pulsation quality with pain that worsens with each pulse.

Most commonly unilateral but may occur on both sides.

Question 11

Migraine Symptoms

Answer 11

N/V
Photophobia (avoidance of light)
Phonophobia (avoidance of light)
Aura (only in classic migraines)

Question 12

Migraine Headaches are usually found in

Answer 12

Women 25-55 years old

Question 13

What can cause a migraine?

Answer 13

Combination of multiple genetic and environmental factors

Question 14

What are the phases of a migraine headache?

Answer 14

Premonitory (predicts a migraine attack around 70% of the time)

1. Aura
2. Headache
3. Recovery

Question 15

What can trigger a migraine?

Answer 15

Altered sleep patterns
Skipping meals
Overexertion
Weather change
Stress or relaxation from stress
Hormonal changes (menstrual periods)
Excess after eat stimulation (bright lights, strong smells)
Chemicals (alcohol or nitrates)

Question 16

Antimigraine Drugs include

Answer 16

Triptan’s (serotonin agonists): first line therapy for migraines
Ergot alkaloids

Question 17

Most common Triptans include

Answer 17

Sumatriptan

All end in “-triptan”

Question 18

Ergot Alkaloids include

Answer 18

“Ergot” in name

Question 19

Triptans MOA

Answer 19

Stimulates 5-HT (serotonin) receptors in cerebral arteries, causing vasoconstriction -> reducing headache symtpoms
Reduces the production of inflammatory neuropeptides

Question 20

Ergot Alkaloids: MOA

Answer 20

Narrow or constrict blood vessels to the brain

Question 21

Adverse Effects of Triptans

Answer 21

Vasoconstriction
Irritation to injection site
Tingling, flushing
GI upset

Question 22

Triptans are contraindicated in what patients?

Answer 22

Patients with serious CVD

Question 23

Adverse Effects of Ergot Alkaloids

Answer 23

**N/V
Cold or clammy hands and feet
Muscle Pain
Dizziness 
Tachycardia

Question 24

What are other drugs for migraine prophylaxis?

Answer 24

Anti-seizure drugs (topamax)
Beta-adrenergic blockers (propranolol)
Calcium Channel Blockers (verapamil)
Tricyclic anti-depressants (amitriptyline)