EXAM 1 - Neurosensory- HA Flashcards

Various types of Headaches

1
Q

What are the medication names of the triptans?

A

sumatriptan (original), almotriptan, eletriptan, naratriptan, rizatriptan, zolmitriptan, fovatriptan

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2
Q

What medications are used for Cluster headaches?

A

triptans, ergotamine preperations, CCBs, antiepileptics

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3
Q

What should patients take for mild migraines?

A

NSAIDS (motrin), Acetaminophen

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4
Q

When should a client seek emergency care for any type of headache?

A
  • 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
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5
Q

What kind of O2 treatment can be used for cluster headaches?

A

High flow 12 to 15 L OR via facemask for 15 to 20 minutes

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6
Q

A type of migraine where flashes of light or different visuals, such as diplopia (seeing double) occur.

A

Migraine with aura

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7
Q

what can be taught to a patient about cluster headaches?

A
  • Avoid direct sunlight
  • Importance of proper sleep/wake cycles
  • teach patients to avoid triggers
  • Relaxation techniques
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8
Q

When should a client suffering from tension headaches contact HCP?

A
  • If taking medications twice a weekly as opposed to once

- If pattern of HA changes

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9
Q

Anti hypertensives used to treat migraines?

A
  • preventative therapy - verapamil , amlodipine, timolol, propranolol
  • Prevents vasoconstriction or vasodilation in cerebral blood vessels
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10
Q

mechanism of action for ergot alkaloids?

A

constrict blood vessels in brain

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11
Q

What are the phases of migraine headaches?

A
  1. premonitory/prodromal phase
  2. aura phase
  3. headache phase
  4. postdromal phase
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12
Q

What is a primary headache?

A
  • Not associated with other diseases.

* Migraine, tension, cluster.

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13
Q

how does caffeine assist with migraines?

A
  • abortive therapy
  • enhance effect of analgesics
  • enhance intestinal absorption of ergot alkaloids
  • vasoconstriction reducing cerebral blood flow
  • diuretic effect
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14
Q

beta blockers used to treat migraines?

A

preventative - timolol and propranolol

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15
Q

phase of migraine where intensity decreases, fatigue occurs, periods of confusion may occur.

A

postdromal/termination phase

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16
Q

adverse effects of triptans?

A

vasoconstriction, irritation at injection site, tingling and flushing

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17
Q

What are the characteristics of the pain felt during migraine headache?

A

unilateral, frontotemporal, throbbing, felt behind eye or ear.

18
Q

What are the characteristics of pain of a cluster headache?

A
  • unilateral
  • oculotemporal/frontal
  • excruciating and non throbbing
  • radiates to forehead, temple or cheek
  • patient will often pace, sit and rock during attack
19
Q

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).

A

Headache phase

20
Q

What should patients take for severe migraines?

A

Triptan preparations, ergotamine derivatives

21
Q

adverse effects of ergot alkaloids?

A

N/V, Cold and clammy hands and feet, muscle pain, dizziness

22
Q

Characteristics of Tension Headache?

A
  • 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
23
Q

What is the three R approach for headaches?

A
  • Recognize migraine symptoms
  • Respond and see the health care provider
  • Relieve pain and associated symptoms
24
Q

what are the various ergotamine medications?

A
  • 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)
25
Q

What does SNOOP stand for?

A
  • 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.
26
Q

antiepileptic drug used for migraines? how?

A
  • preventative therapy - phenytoin, lamotrigine, gabapentin

* increase levels of nuerotransmitters and diminish pain impulses

27
Q

Migraine headache characteristics

A
  • Unilateral throbbing pain

* nausea, sensitivity to light and pain/symptoms lasting 4 to 72 hours

28
Q

mechanism of action for triptans?

A
  • Abortive therapy - stimulate 5-HT (hydroxytryptamine) receptors in cerebral arteries, causing vasoconstriction and reducing headache symptoms.
  • Reduce production of inflammatory neuropeptides
29
Q

phase of migraine headache where specific symptoms occur: mood changes, fluid retention, food cravings..etc.

A

premonitor/prodromal phase

30
Q

What are contraindications of triptans?

A

ischemic heart disease, cerebrovascular ischemia, Hypertension, PVD//Patients on SSRI’s, SNRIs, St. johns wort, and pregnant women

31
Q

What kind of foods cause headaches?

A
  • Caffeine
  • red wine
  • MSG
  • aspartame
  • processed meats
  • aged cheese
32
Q

What are some antidepressants used to treat migraines and how?

A
  • preventative
  • SSRI and Trycyclic
  • increasing serotonin, dopamine, norepinephrine
33
Q

Patient teaching for Triptans?

A

Take as soon as migraine develops, report chest pain

34
Q

Which two types of headaches are difficult to distinguish?

How can you distinguish the two.

A

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
35
Q

Ways to help diagnose migraine headache?

A

MRI, CT SCAN, PT history, neurological assessment

36
Q

Common side effects for triptans?

A

flushing, tingling, hot sensation

37
Q

what are the characteristics of a cluster headache?

A
  • 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)
38
Q

contributing factors to migraines?

A

Genetics, Females, stress, Drugs, hypoglycemia, exercise, Diet (foods high in tyramines)

39
Q

What are the four common types of headaches?

A

Sinus, Tension, Migraine, Cluster

40
Q

What is the first line of medication therapy for migraines?

A

Serotonin agonists/triptans

41
Q

A common cause of a headache is caused by blood vessel inflammation in head, known as….

A

Cranial Arteritis

42
Q

What is a secondary headache?

A
  • Associated with other issues and do not resolve until those issues are addressed.
  • Intracranial issues such as brain tumor, bleeding, inflammation