headache 5 Flashcards
what is the role of opiate analgesics in headache treatment
“rescue therapy” usually used when others have failed
what are 2 issues with opiate analgesic use for headaches
- rebound headache
2. dependence
what are 3 ways antiemetics help for migraine treatment
- helps with nausea associated with migraine
- nausea associated with medication
- refractory headache relief
what type and specific drugs are the antiemetics used for migraines
Dopamine agonists:
- metoclopramide
- chlorpromazine
- prochlorperazine
what antiemetics are no good for treating headaches
serotonin agents (ondansetron…)
what is contained in Treximet
sumatriptain and naproxen
what are the acute migraine management goals (6)?
- treat attacks rapidly and consistently without recurrence
- restrore patients ability fo function
- minimize use of rescue meds
- optimize self care
5 cost effective - minimal or no adverse effects
when should non-oral route be selected for migraine management
if migraines present with nausea or vomiting
acute migraine therapy should be limited to how often
2-3 days per week
selection of migraine therapy should be based on what?
- level of evidence
- comorbid conditions
- side effect profile
- drug interactions
what beta blockers can be used to treat migraines
- propranolol
- timolol (eye drops)
- metoprolol
what type beta blockers are not effective for migraines?
Intinsic symptathomimetic activity (ISA).
betablockers are preferred in patients with what 3 concamittant conditions
- angina
- hypertension
- anxiety
if someone has heart failure and migraines, what is the best drug to pick
metoprolol
what tricyclic antidepressant is used for headaches?
amitriptyline
how does amitriptyline work to relieve headaches?
what are its main side effects?
down regulation of serotonin receptors
- anticholinergic
- cardiac
- sedation
what SSRI can be used to treat migraines
none; can worsen it
what anticonvulsants can be used to treat migraines
- Depakote
- topiramate
- carbamazepine (not as often)
what is the biggest side effect seen with topiramate
memory difficulties
when are NSAIDs to be taken for best treatment of migraines
1-2 days before a predictable pattern headache
how long does it take for verapamil (CCBs) effect to be seen on migraines
8 weeks
what are some natural migraine remedies with evidence indicating they are effective
- butterbur
- riboflavin
- Co-Q 10
- botulism toxin injections
