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Neuro > Headache > Flashcards

Headache Flashcards

1
Q

Characteristics of Tension type ha?

A

30 minutes to 7 days, with pressing. nonpulsatile pain, mild-mod intensity, usually bilateral. 5:1

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2
Q

characteristic of migrie without aura?

A

4-72 hours, unilateral, occ bilateral, pulsating, mode- severe. agg w/activity, n/v. photophobia, phonophobia.

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3
Q

Character of migraine with aura

A

migraine + aura symptoms over 4 minutes - two or more symptoms in succession. dread and anxiety, fatigue, anxiety. GI upset, visual, olfactory alteration. aura should end in 1 hour.

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4
Q

Cluster headache symptoms?

A

occur daily in groups or clusters. clusters can last weeks to months. then disappear. wakes in sleep within 1 hour. HA behind eye with stead intense severe pain lasting 15min- 30 min. often occurs with increased lcarimation, conjuctival infection, ptosis, nasal stuffy.

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5
Q

Headache Red Flags?

A

systemic symtpoms - fever. WL
neuro - confusion, NRigidity, hypetension, papilledema, CN dxn, abn motor fxn.

Onset- sudden abrupt, thunder! with exertion soughing or sneezing.

> 50 years ol

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6
Q

What medication works as prophylaxis for both tension HA and migraines?

A

triptans

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7
Q

Abortive therapy for cluster HA?

A

NSAIDS
triptans
high flow oxygen

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8
Q

what injectable forms tx available?

A

abortive ergots and triptan

ergot can be given IV
triptan IM

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9
Q

What nasal sprays available?

A

supatriptan (imitrix)
zolmitriptan

droergotamine

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10
Q

what antiemetic commonly used?

A

prochlorperazine (compazine), odndanstron, reglan (limit this one though since EPS)

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11
Q

MOA of triptans?

A

SSR agonist and at 5 ht1D serotonin receptor site. vasoconstricting potential

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12
Q

CI of triptans among what conditions?

A

angina, CAD, pregnancy, recently used ergots. caution with MAOI or SSRI

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13
Q

MOA of ergotamines?

A

5HT1A and 1D agonist. alter cerebral flow. vasocontrictor effect.

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14
Q

CI of ergots?

A

pregnancy, CAD

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15
Q

Treatment of tension HA?

A

NSAIDS (acetimnophen, *Excedrine maigrain - ASA + acet + caffeine)
triptan

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16
Q

Treatment of cluster HA?

A

1) NSAID

2) systemic corticosteroids - severe cases

17
Q

Abortive Treatment of migraine?

A

1) NSAID
* acetiminophen
* ASA
* naproxen sodium is better than others often
* Excedrine maigrain - ASA + acet + caffeine

2) ergot
3) triptan
4) floricet - combo of ceffeine + butalbital + acetim

5) NEuroepileptics - first generation such as procholorperazine (compazine), promethazine (phenergan).
6) . systemic corticosteroids - severe cases
7) opioids - hydrocodone and oxycodone (migraine rescue)

18
Q

How long before prophyalxis effects seen in prevention?

A

1-2 mo

19
Q

What must occur before prophylaxis can be implemented?

A

estrogen, prog, vasodilators need to eliminated or limited.

20
Q

Prevention migraines?

A 
triptans
ergots?
BB - 
antiepileptics 
some antidepressants (Tryciclics, ans SSNRI)
21
Q

what BB has no benefits for migraine prevention?

A

acebutolol.

22
Q

which BB have effect for migraine prevention

A

metoprolol and propranolol. atenolol and nadolol a little effect.

23
Q

What antiepileptics effective for migraine prevention?

A
  • divalproez sodium, sodium valproate, topiramate.
24
Q

What AED is not recommended for prevention of migraines?

A

lamotrigine.

25
Q

Tricyclics poss for migraine proph?

A

nortiptyline and amytriptyline

26
Q

SSNRI’s useful for migrain proph?

A

venlafaxine.

27
Q

minerals and vitamins helpful in proph?

A

butterbur, riboflavin, mg, feverfew, estrogen supplementation during premenstrual week.

28
Q

Triggers for headaches?

A

Menses, BC, sleep dx, lights, odors, weather, hugh altitudes, medications, stress

food: sour cream, ripening cheest, sausage/bolog/salami, pizza, herring, pickled foods, MSG, bakers years. beans, onions, citrus fruit, bananas, caffeine, etoh, aspartame.

Neuro (10 decks)

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