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Pharm Exam 1 > HA > Flashcards

HA Flashcards

1
Q

Pharm concept for attacking TTH

A

HIT hard and EARLY

–limit use to <9d/month of drugs to decrease risk of MOH

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2
Q

what increases risk of MOH

A

combination of analgesics; caffiene, butalbital, opioids

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3
Q

what decreases risk of MOH

A

long life NSAID–naproxen

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4
Q

initial therapy for TTH

A

ibuprofen/naproxen + APAP

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5
Q

in pt drug for TTH abortion

A

ketroalac

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6
Q

combination drug for TTH abortion

A

excedrin (caffiene + APAP+ ASA)

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7
Q

what should be used w/ pregnancy and TTH

A

APAP

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8
Q

what is the most helpful tool w/ Migranes

A

Headache Diary

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9
Q

important consideration for meds to treat migranes

A

consider non ORAL route

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10
Q

abortive meds for mild-mod migranes

A

NSAID +/- APAP
Traiptan
Ergot

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11
Q

what meds should be used for anti-emetics w/ migranes

A

IV dopamine if possible
metoclopramide
prochlorperazine
promethazine

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12
Q

what drug should ALWAYS be avoided with migranes?

A

OPIOIDS

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13
Q

Sumitriptan forumulations

A

tab
nasal spray
SQ

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14
Q

Triptan drugs

A

sumitriptan

zolmitriptan

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15
Q

short onset triptan

A

sumitriptan

Zolmitriptna

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16
Q

long onset triptan

A

frovatriptan

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17
Q

longest lasting triptan–good for repeat migranes in 1 day

A

frovatriptan and naratriptan

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18
Q

MOA of triptans

A

SSRI agonist causing vasoconstriction

19
Q

what pts should not use triptans

A 
HTN pts
Pheo pts
TIA history pts
Raynauds pts
"Vasculopaths"
20
Q

what is the most effective route for migranes

A

SQ

21
Q

if a pt doesn’t respond to a triptan what should you do?

A

try another one! pts can respond to different ones

22
Q

what triptan is used with cluster HA?

A

sumitriptan

23
Q

what drug do triptans interact with and should be avoided

A

with MAOI

24
Q

what drug should not be given with triptans d/t similar effects

A

ergots and SSRI

25
Q

what can propranol do if given with triptans? how should you alter your prescription?

A

increase concentration, you may need to decrease triptan doseage

26
Q

what can propranol do if given with triptans? how should you alter your prescription?

A

increase concentration, you may need to decrease triptan dosage

27
Q

what ergot do we use?

A

dihydroergotamine

28
Q

what is the MOA of ergots?

A

similar to triptan–with serotonin agonists

29
Q

when should ergots be used?

A

in pts who failed therapy with triptans

30
Q

what is a GI ADR of drihydroergotamine?

A

diarrhea

31
Q

what is a common drugs for migrane prophylaxis?

A

B-blockers
AEDS
Anti-depressants

32
Q

who do we avoid B-blockers in?

A

asthmatics
HF pts
ppl w/ exercise intolerance

33
Q

who should we use toprimate in?

A

adolescents & adults

34
Q

what is important to know about divalproxe/VPA?

A

TERATOGEN

35
Q

what anti-depressant is used?

A

amitriptyline

36
Q

what is drug helpful w/ menstrual migraines?

A

OCP and esp. w/ extended cycle to skip periods and avoid the migranes

37
Q

what can be done prophylactically for menstrual migranes

A

take triptan or nsaid 2d before menses & continue for 5-7 days

38
Q

what are the CGRP antagonists?

A

Erenumab
Fremanzumab
Galcanzumab

39
Q

what important about the formulation of the new CGRP drugs?

A

INJECTIONS

40
Q

what is the mOA of CGRP antagonist??

A

vasodilator

inhibits pain signalling neutrotransmission

41
Q

when do we use CGRPs?

A

when other meds AREN’T working or aren’t tolerated

42
Q

what CGRP has a bad ADR? what is the ADR?

A

Erenumab–hypersensitivity rxn, angioedema, anaphylaxis

43
Q

what migrane drugs can be used in pregnancy?

A

APAP

sumitriptan–category C

44
Q

what drugs need to be avoided in pregnancy

A

nsaid–esp 3rd trimester

ergots

Pharm Exam 1 (9 decks)

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