Headaches

Question 1

the most common neurologic reason for pain

Answer 1

headaches

Question 2

before treating a headache what do we want to look for

Answer 2

cause of the headache

Question 3

3 types of headache

Answer 3

migraine, cluster, tension

Question 4

headache trt is prescribed as 1 of 2 therapies what are they

Answer 4

abortive therapy (person already has headache) or preventive therapy (prone to headaches)

Question 5

drugs for severe headaches can cause dependence, t or f

Answer 5

true

Question 6

migraine headache abortive trt (2 types)

Answer 6

nonspecific analgesics - opiods/aspirin-like drugs

migraine specific drugs - ergot alkaloids and serotonin agonist

Question 7

mild to moderate migraine pain trt.

Answer 7

apirin like drugs (aspirin, acetaminophen, NSAID, ibuprofen)

Question 8

is acetaminophen an effective trt for migraines

Answer 8

no - not when used alone

Question 9

severe migraine trt

Answer 9

opiods - (Demerol as a nasal spray)

Question 10

prototype drug for migraine headaches

Answer 10

imitrex (triptan)

Question 11

how is imitrex given

Answer 11

PO, intranasal, sub Q

Question 12

imitrex MOA

Answer 12

activates serotonin receptors causing vaso-constriction

Question 13

is imitrex used for preventive or abortive therapy

Answer 13

abortive

Question 14

s/e of imitrex

Answer 14

chest/arm symptoms (chest pressure/heavy arms)
w/cardiac hx not good candidate for this drug
coronary vasospasms
teratogenic

Question 15

can imitrex (triptans) be combined with other migraine meds

Answer 15

no, specifically ergotamine (ergo alkaloids)

Question 16

how does ergotamine work

Answer 16

vasoconstriction - too much

Question 17

imitrex is contraindicated with

Answer 17

hx of MI
HTN
family hx of cardiac disease
epilepsy

Question 18

ergotamine (ergot alkaloids) can be given

Answer 18

sub-lingual

rectally

Question 19

MOA for ergotamine

Answer 19

causes vaso-constriction

Question 20

reasons ergotamine might not be commonly prescribed

Answer 20

addictive quality (caffeine like) -  can cause euphoria
rebound headaches when you stop taking it
therapeutic window is a lot more narrow

Question 21

s/s of overdose on ergotamine

Answer 21

***cold/pale/numbness/tingling in extremities

tachycardia

Question 22

preventive (prophylactic) migraine therapy guarantees headaches will stop, t or f

Answer 22

false - can limit severity or frequency making them more manageable

Question 23

drugs used for prophylactic/preventative migraine trt

Answer 23

*Propanolol (beta blockers/calcium channel blockers)
Elavil (tricyclic antidepressants)
Divalproex, Topamax (anti-seizure drugs)
Estrogen's
Botox
Avoidance of known triggers

Question 24

how does propanolol work

Answer 24

unknown - thought to decrease anxiety

Question 25

how long will it take to see the benefit from propanolol

Answer 25

several weeks

Question 26

trt practices for cluster headaches

Answer 26

based on prophylactic care

Question 27

specific drugs for cluster headaches

Answer 27

prednisone, lithium, verapimil, triptans, ergotamines

Question 28

best trt for cluster headaches

Answer 28

high flow oxygen - reason unknown

Question 29

trt for tension headaches

Answer 29

OTC meds

Question 30

preventative trt for tension headaches

Answer 30

elavil (anti-depressant)

***stress mgmt techniques