Headaches Flashcards
Analgesics
COX inhibitors - acute treatment of moderate migraine and tension headaches (most common headache). Naproxen, Ketorolac, Indomethacin
Barbiturates
GABAa agonist - Acute treatment of migraines; use when more traditional therapies are unavailable/contraindicated
Opioids
Acute treatment of migraines
Corticosteroids
Acute treatment of migraines and cluster headaches
Ergotamines
Vasoconstriction and/or 5-HT agonist in trigeminocascular pathway possible mechanism? - for acute treatment of migraines. Do not use if possibly pregnant, uncontrolled hypertension, renal or hepatic failure, vascular disease
DHE
Vasoconstriction and/or 5-HT agonist in trigeminocascular pathway possible mechanism? - for acute treatment of migraines and cluster headaches. Do not use if possibly pregnant, uncontrolled hypertension, renal or hepatic failure, vascular disease
Sumatriptan
TRIPTAN. Premier migraine drugs. selective 5-HT agonists, prenetrate CNS, contrict extracerebral intracranial vessels, inhibit trigeminocascular system - for chronic migraine headaches
Onabotulinum toxin (Botox)
unknown mech, possibly decreased afferent stimulation of trigeminocascular system or down regulation of sensory and parasympathetic receptors - for chronic migraine headaches
TCA
(Tricyclic antidepressants) migraine and tension headache prevention. Amitriptyline, Protriptyline, Nortriptyline
SSRI’s
migraine and tension headache prevention. Fluoxetine, Paroxetine, Sertraline
Beta-blockers
Antihypertensives - migraine prevention (only propranolol and timolol FDA approved). Propranolol, Timolol, Nadolol, Atenolol. Contradicted in asthma, diabetes, CHF, or Raynauds (cold temp => blood vessel spasms)
Calcium Channel Blockers
Verapamil (antihypertensives) - migraine prevention (specifically with aura) and long term cluster headache prevention
Oxygen
Acute treatment of cluster headaches (70% effective)
Anti-epileptics
Divalproex sodium ER (Valproic Acid) and Topiramate - lots of side effects, need to be monitored
