Headache Flashcards
What was the believed cause of headaches in the past?
demons, they would place people’s heads in an oven to get rid of the demon
what is trepanation?
It was used as a cure for headaches. Surgey: drilling a hole in ones head. Has life long effect (hole in head)
peter howardson still believes this - must relieve pressure, let demons escape
Does the brain feel pain?
No
What are the two classes of headaches?
muscular + vascular
How does a muscular headache happen?
The muscle bands around the skull contract and put pressure on the tissue surrounding the skull
What is one main cause of a muscular headache?
stress
What is the best treatment for a muscular headache?
A.S.A, Ibuprophen, and Naprox work best cause they work with prostaglandins which relax muscles
What are two types of vascular headaches?
Toxic + Migraine
What causes a toxic headache?
toxins, poison
- the brain wants to release and get rid of the poison so the blood vessels dilate to make room for this which puts pressure on the tissue around the skull.
main one is alcohol = hangover
what is it called when blood vessels dilate or contract?
vasodilation + vasoconstriction
explain the process of alcohol expulsion. What enzymes are involved? Which causes the hangover?
There are 2 chemical reactions that occur involving 2 enzymes: alcohol dehydrogenase, and acetaldehyde dehydrogenase.
- Acetic acid is a good end product = no hangover
- acetaldehyde harms the liver
- more enzymes = less hangover, unless there’s an imbalance and there’s more acetaldehyde.
- Asians have more of this enzyme
What drug is used to cure alcoholics? why?
disulfiram (antabuse)- it blocks the second enzyme which makes them sick and not want to drink cause it doesn’t create acetic acid
what makes certain alcohols more likely to give a hangover?
age- the darker color, toxins from the wood.
Should you take acetaminophen with alcohol? why?
No because alcohol activates CP450 which is linked with liver toxicity. Acetaminophen is linked with the same thing so this would be toxic for the liver
What in red wine, chocolate cheese, and hotdogs gives headaches?
histamines, phenalthylamine, tyramine, nitrates (nitroglycerine)- vasodilator)
when were MSG’s discovered? how?
- 1907
- man discovered it in seaweed after realizing it enhanced flavours in food
- knowck syndrome (Chinese restaurant syndrome): eating Chinese food = headaches -> due to MSG
NOT true
What are MSGs disguised as?
Hydrolyzed vegetable protein
What is MSG in our bodies?
a metabolite (5% of protein)
How does caffeine cause headaches?
- it is actually a vasoconstrictor
- when someone drinks coffee heavily, going without it will trigger the chemicals and our body will want the vessels to dilate
*rebound headache
who do migraines affect?
6% men, 18% women
What produces a migraine?
Both vasodilation and vasoconstriction
- caused by a specific trigger
what are 4 phases of a migraine?
prodrome: occurs 1-2 days before, mood swings
aura: effects felt 1-2 hrs before
- hallucinations, sarcoma, sensitivity etc..
pain: occurs on one half of the head, nausea, lasts 1-72hrs
postdrome: “hung over” feeling, exhaustion,
What medication can abort a migraine?
Tryptans
What is the history of finding triptans? (Rye bread)
a fungus that would grow on rye was called ergot,. When consumed it would alter peoples behaviors and cause hallucinations. People thought that those acting out after consuming ergot were possessed my demons
- they were interpreted as being witches
was used by midwives to induce labour - muscle contractions (small dose was okay)
- very deathly poison - causes gangreen + death
When was it discovered that with a proper dose it could be good for migraines?
1962
What is the active ingredient related to Ergot? who discovered it? what is the med that is sold today but not drug-like?
Ergotamine (arthur stoll), cafergot
Who discovered LSD? What does it have a similar structure to?
Albert Hoffman, ergotamine
Importants of seratonin, migraines and drugs
serotonin lvls change during a migraine but if we replace the lost serotonin with a drug that can fit into he proper receptors we can prevent a migraine… especially during the aura stage
what was the first triptan drug?
sumatriptan
