Headache Drugs Flashcards

1
Q

Analgesics MOA

A

Inhibition of COX (COX2 may be preferential)

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2
Q

Analgesics Therapeutics

A

Acute treatment of moderate migraine (combination of acetaminophen, aspirin, and caffeine); acute treatment of tension headaches

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3
Q

Barbiturates Therapeutics

A

Acute treatment of migraines; use when more traditional therapies unavailable or contraindicated

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4
Q

Barbiturates SE

A

Drowsiness, dizziness

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5
Q

Barbiturates Misc

A

Use limited to 2-3 times per week

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6
Q

Opioids Therapeutics

A

Acute treatment of migraines; patients with infrequent headaches; generally, for patients who wake up with a headache

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7
Q

Opioids Misc

A

Use less than 2 days per week; pregnant women may use codeine or meperidine with caution

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8
Q

Corticosteroids Therapeutics

A

Acute treatment of migraines; migraine, prolonged headache syndromes (e.g., chronic daily headache); rescue treatment of cluster headache

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9
Q

Corticosteroids Misc

A

Chronic medicaton/overuse most common cause of chronic daily headaches

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10
Q

Ergotamines MOA

A

Vasoconstriction possibly; may also act as a 5HT agonist in trigeminovascular pathway

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11
Q

Ergotamines Therapeutics

A

Acute treatment of migraines

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12
Q

Ergotamines SE

A

Nausea, dizziness, paresthesia, chest pain, abdominal cramps

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13
Q

Ergotamines MIsc

A

Contraindicated in women planning pregnancy, uncontrolled HTN, sepsis, renal or hepatic failure, vascular disease

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14
Q

DHE (Migranal) MOA

A

Vasoconstriction possible; mainly act as a 5HT agonist in trigeminovascular pathway

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15
Q

DHE (Migranal) Therapeutics

A

Acute treatment of migraines; less likely to cause rebound headache than ergotamines; acute treatment of cluster headaches; short-term prevention of cluster headaches (along with steroids)

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16
Q

DHE (Migranal) SE

A
  1. Nausea (less likely than ergotamines), dizziness, paresthesia, chest pain, abdominal cramps
17
Q

DHE (Migranal) Misc

A

Contraindicated in women planning pregnancy, uncontrolled HTN, sepsis, renal or hepatic failure, vascular disease; injectable

18
Q

Sumatriptan (Imitrex) Class

A

Triptan

19
Q

Sumatriptan (Imitrex) MOA

A

Selective 5HT1b-d agonists; penetration of CNS, constriction of extracerebral intracranial vessels, inhibition of trigeminovascular system

20
Q

Sumatriptan (Imitrex) Therapeutics

A

Acute treatment of migraines (premier option); also effective for photo/phonophobia, nausea and vomiting; acute treatment of cluster headaches

21
Q

Sumatriptan (Imitrex) SE

A
  1. Flushing, tingling, dizziness, chest discomfort (noncardiac)
22
Q

Sumatriptan (Imitrex) Misc

A

Contraindicated in vascular disease (including Prinzmetal), uncontrolled HTN, complicated migraine; injectable (suma)

23
Q

Onabotulinum toxin (Botox) MOA

A

Unknown (possibly decreased afferent stimulation of trigeminovascular system, or downregulation of sensory and parasympathetic receptors)

24
Q

Onabotulinium toxin (Botox) Therapeutics

A

Acute treatment of chronic migraine headaches

25
Q

Onabotulinium Toxin (Botox) SE

A

Injection site pain, headache, neck weakness, ptosis

26
Q

TCA Therapeutics

A

Migraine prevention, tension headache prevention

27
Q

TCA SE

A

Dry mouth, constipation, weight gain, cardiac toxicity, orthostatic hypotension

28
Q

TCA Misc

A

Amitriptyline, protriptyline, nortriptyline

29
Q

SSRIs Therapeutics

A

Migraine prevention, tension headache prevention

30
Q

SSRIs SE

A

Weight gain, sexual dysfunction, headache

31
Q

SSRI Misc

A

Fluoxetine, paroxetine, sertraline

32
Q

Beta-blockers Therapeutics

A

Migraine prevention (only propranolol and timolol FDA approved)

33
Q

Beta-blockers SE

A

Drowsiness, depression, decreased libido, hypotension, memory disturbance

34
Q

Beta-blockers Misc

A

Propranolol, timolol, nadolol, atenolol; contraindicated in asthma, diabetes, CHF, or Raynaud’s

35
Q

Calcium CHannel Blockers Therapeutics

A

Migraine prevention; particularly useful in prolonged or disabling aura, or complicated migraine syndromes (e.g., hemiplegic migarine); long-term prevention of cluster headaches

36
Q

Calcium Channel blockers SE

A

Constipation, dizziness

37
Q

Calcium CHannel Blockers Misc

A

Verapamil most commonly used

38
Q

Oxygen Therapeutics

A

Acute treatment of cluster headaches

39
Q

Oxygen Misc

A

Rebound can occur when oxygen stopped