Exam 3 - Lec 50 Migraines Ott Flashcards
migraine without aura (common) diagnostic criteria (4 things)
-at least 5 attacks
-headache lasting 4-72 hours
-unilateral location, pulsating, moderate/severe pain, aggravation by routine activity
-N/V, photophobia, phonophobia (fear of sound)
migraine with aura (classic) diagnostic criteria (5 things)
-at least 2 attacks
-at least one fully reversible aura
-no aura lasting more than 60 min
-headache follows aura within 60 min
-aura symptoms: visual, sensory, speech/language, motor, brainstem, retinal
4 migraine headache phases
- prodrome (hours or days before onset of headache)
- aura (before or during migraine, lasts < 60 min)
- migraine headache
- postdromal (may last several days after headache ended)
a pt may experience euphoria, depression, irritability, food craving, constipation, neck stiffness, and yawning during which stage of a migraine headache?
a. prodrome
b. aura
c. migraine headache
d. postdromal
a. prodrome
what is a medication overuse headache?
rebound headaches from medication overuse more than two times per headache or two times per week chronically (associated with analgesics, ergots, triptans)
medications that trigger migraines (5 of them)
-oral contraceptives
-hydralazine
-NTG
-nifedipine
-cocaine
analgesics should be limited for abortive tx of migraines for max of ___-___ days per week
2-3 days
what medications are used for mild-moderate abortive tx of migraines? (2 of them)
a. triptans
b. NSAIDs
c. ergots
d. acetaminophen
b. NSAIDs
d. acetaminophen
what medications are used for moderate-severe abortive tx of migraines? (2 of them)
a. triptans
b. NSAIDs
c. ergots
d. acetaminophen
a. triptans
c. ergots
preventive tx for migraines is used when there are _____ or more attacks/month with disability at least _____ days/month
4; 3
NSAIDs such as ketoprofen, IV and IM ketorolac, and flurbiprofen are _____ line for abortive tx of migraines
second
triptans and NSAIDs such as aspirin, diclofenac, ibuprofen, and naproxen are _____ line for abortive tx of migraines
first
first line monotherapy for preventive tx of migraines (5 drugs in bold)
-valproate
-topiramate
-metoprolol
-propranolol
-frovatriptan
second line monotherapy for preventive tx of migraines
a. amitriptyline
b. metoprolol
c. propranolol
d. topiramate
e. valproate
a. amitriptyline
Look at slide 11 for non-pharm therapy
Ok