EXAM 1 - Neurosensory- HA Flashcards
Various types of Headaches
What are the medication names of the triptans?
sumatriptan (original), almotriptan, eletriptan, naratriptan, rizatriptan, zolmitriptan, fovatriptan
What medications are used for Cluster headaches?
triptans, ergotamine preperations, CCBs, antiepileptics
What should patients take for mild migraines?
NSAIDS (motrin), Acetaminophen
When should a client seek emergency care for any type of headache?
- Abrupt and severe HA
- HA accompanied by stiff neck, confusion, seizures, double vision, weakness, numbness, or difficulty speaking
- HA after head injury that keeps getting worse
What kind of O2 treatment can be used for cluster headaches?
High flow 12 to 15 L OR via facemask for 15 to 20 minutes
A type of migraine where flashes of light or different visuals, such as diplopia (seeing double) occur.
Migraine with aura
what can be taught to a patient about cluster headaches?
- Avoid direct sunlight
- Importance of proper sleep/wake cycles
- teach patients to avoid triggers
- Relaxation techniques
When should a client suffering from tension headaches contact HCP?
- If taking medications twice a weekly as opposed to once
- If pattern of HA changes
Anti hypertensives used to treat migraines?
- preventative therapy - verapamil , amlodipine, timolol, propranolol
- Prevents vasoconstriction or vasodilation in cerebral blood vessels
mechanism of action for ergot alkaloids?
constrict blood vessels in brain
What are the phases of migraine headaches?
- premonitory/prodromal phase
- aura phase
- headache phase
- postdromal phase
What is a primary headache?
- Not associated with other diseases.
* Migraine, tension, cluster.
how does caffeine assist with migraines?
- abortive therapy
- enhance effect of analgesics
- enhance intestinal absorption of ergot alkaloids
- vasoconstriction reducing cerebral blood flow
- diuretic effect
beta blockers used to treat migraines?
preventative - timolol and propranolol
phase of migraine where intensity decreases, fatigue occurs, periods of confusion may occur.
postdromal/termination phase
adverse effects of triptans?
vasoconstriction, irritation at injection site, tingling and flushing
What are the characteristics of the pain felt during migraine headache?
unilateral, frontotemporal, throbbing, felt behind eye or ear.
What are the characteristics of pain of a cluster headache?
- unilateral
- oculotemporal/frontal
- excruciating and non throbbing
- radiates to forehead, temple or cheek
- patient will often pace, sit and rock during attack
Phase of migraine that lasts a few hours to days, involves severe pain and is often associated with photo/phono phobia and allodynia (nerve pain).
Headache phase
What should patients take for severe migraines?
Triptan preparations, ergotamine derivatives
adverse effects of ergot alkaloids?
N/V, Cold and clammy hands and feet, muscle pain, dizziness
Characteristics of Tension Headache?
- Dull, aching head pain
- sensation of tightness or pressure across the forehead or sides and back of head
- tenderness on scalp/neck/shoulder muscles
- Stress may be a trigger
- Episodic -30 minutes to a week VS. Chronic – 15 days or more in a month for 3 months
What is the three R approach for headaches?
- Recognize migraine symptoms
- Respond and see the health care provider
- Relieve pain and associated symptoms
what are the various ergotamine medications?
- Ergotamine tartrate w/ caffeine (cafergot and migergot)(oral or suppository)
- ergotamine sublingual
- medihaler ergotamine - oral inhalation
- Dihydroergotamine meslayte (DHE 45) - injectable and nasal spray (migranal)
What does SNOOP stand for?
- Systemic symptoms/Risk factors - E.g. Fever/cancer
- Neurologic symptoms/abnormal signs - e.g. confusion, motor weakness
- Onsent - Sudden, abrupt, rapid
- Older - New HA in older pt or Progressively worsening HA in middle aged (>50).
- Progression - Previous HA history - major change in frequency, severity, features - unlike any experienced before.
antiepileptic drug used for migraines? how?
- preventative therapy - phenytoin, lamotrigine, gabapentin
* increase levels of nuerotransmitters and diminish pain impulses
Migraine headache characteristics
- Unilateral throbbing pain
* nausea, sensitivity to light and pain/symptoms lasting 4 to 72 hours
mechanism of action for triptans?
- Abortive therapy - stimulate 5-HT (hydroxytryptamine) receptors in cerebral arteries, causing vasoconstriction and reducing headache symptoms.
- Reduce production of inflammatory neuropeptides
phase of migraine headache where specific symptoms occur: mood changes, fluid retention, food cravings..etc.
premonitor/prodromal phase
What are contraindications of triptans?
ischemic heart disease, cerebrovascular ischemia, Hypertension, PVD//Patients on SSRI’s, SNRIs, St. johns wort, and pregnant women
What kind of foods cause headaches?
- Caffeine
- red wine
- MSG
- aspartame
- processed meats
- aged cheese
What are some antidepressants used to treat migraines and how?
- preventative
- SSRI and Trycyclic
- increasing serotonin, dopamine, norepinephrine
Patient teaching for Triptans?
Take as soon as migraine develops, report chest pain
Which two types of headaches are difficult to distinguish?
How can you distinguish the two.
Tension Vs. Migraines
- Tension does not have visual disturbances or N/V
- physical activities don’t make tension headaches worse
- photophobia isnt a common symptom of tension headaches
Ways to help diagnose migraine headache?
MRI, CT SCAN, PT history, neurological assessment
Common side effects for triptans?
flushing, tingling, hot sensation
what are the characteristics of a cluster headache?
- Develop between the ages of 20 and 50 years of age
- Cause unknown - possible neurogenic inflammation
- related to an overactive and enlarged hypothalamus
- Rhinorrhea
- Ptosis (drooping eye lid)
- eyelid edema
- facial swelling
- Miosis (excessive constriction)
contributing factors to migraines?
Genetics, Females, stress, Drugs, hypoglycemia, exercise, Diet (foods high in tyramines)
What are the four common types of headaches?
Sinus, Tension, Migraine, Cluster
What is the first line of medication therapy for migraines?
Serotonin agonists/triptans
A common cause of a headache is caused by blood vessel inflammation in head, known as….
Cranial Arteritis
What is a secondary headache?
- Associated with other issues and do not resolve until those issues are addressed.
- Intracranial issues such as brain tumor, bleeding, inflammation
