Headaches Flashcards
(30 cards)
the most common neurologic reason for pain
headaches
before treating a headache what do we want to look for
cause of the headache
3 types of headache
migraine, cluster, tension
headache trt is prescribed as 1 of 2 therapies what are they
abortive therapy (person already has headache) or preventive therapy (prone to headaches)
drugs for severe headaches can cause dependence, t or f
true
migraine headache abortive trt (2 types)
nonspecific analgesics - opiods/aspirin-like drugs
migraine specific drugs - ergot alkaloids and serotonin agonist
mild to moderate migraine pain trt.
apirin like drugs (aspirin, acetaminophen, NSAID, ibuprofen)
is acetaminophen an effective trt for migraines
no - not when used alone
severe migraine trt
opiods - (Demerol as a nasal spray)
prototype drug for migraine headaches
imitrex (triptan)
how is imitrex given
PO, intranasal, sub Q
imitrex MOA
activates serotonin receptors causing vaso-constriction
is imitrex used for preventive or abortive therapy
abortive
s/e of imitrex
chest/arm symptoms (chest pressure/heavy arms)
w/cardiac hx not good candidate for this drug
coronary vasospasms
teratogenic
can imitrex (triptans) be combined with other migraine meds
no, specifically ergotamine (ergo alkaloids)
how does ergotamine work
vasoconstriction - too much
imitrex is contraindicated with
hx of MI
HTN
family hx of cardiac disease
epilepsy
ergotamine (ergot alkaloids) can be given
sub-lingual
rectally
MOA for ergotamine
causes vaso-constriction
reasons ergotamine might not be commonly prescribed
addictive quality (caffeine like) - can cause euphoria rebound headaches when you stop taking it therapeutic window is a lot more narrow
s/s of overdose on ergotamine
***cold/pale/numbness/tingling in extremities
tachycardia
preventive (prophylactic) migraine therapy guarantees headaches will stop, t or f
false - can limit severity or frequency making them more manageable
drugs used for prophylactic/preventative migraine trt
*Propanolol (beta blockers/calcium channel blockers) Elavil (tricyclic antidepressants) Divalproex, Topamax (anti-seizure drugs) Estrogen's Botox Avoidance of known triggers
how does propanolol work
unknown - thought to decrease anxiety
