Headaches II Flashcards
chronic sinusitis is not validated as a cause of headache or facial pain unless it _____________
relapses into an acute stage
what are the non-prescription medications for migraines?
- NSAIDs
- aspirin
- acetaminophen
what are the prescription medications for migraines?
- triptans
- dihydroergotamines
- dopamine agonists
what migraine medication is used for fast and specific relief?
triptans
what is the MOA of triptans?
- presynaptic and postsynaptic 5-HT agonists
- block release of vasoactive neuropeptides
what is the pathophysiology of trigeminal autonomic cephalgia?
activation of autonomic symptoms via superior salivatory nucleus - trigeminal autonomic reflex ipsilateral to pain mediated by trigeminal nociceptive afferents
symptoms of cluster headache
- piercing, unilateral stabbing pain
- male 5:1
- ipsilateral lacrimation and nasal congestion
what is the drug of choice for cluster headaches?
verapamil (prevention)
what are the features of hemicrania continua?
- SIDE LOCKED
- no pain free periods - pain can wax and wane
- complete response to indomethacin
what is the most important risk factor for chronic daily headache?
overuse of acute medications
what is a frequent cause of the failure of migraine specific medications to work?
medication overuse headache
what is the first step in MOH?
detox
what does detox entail in MOH therapy?
- absolute removal of offending medications
- establishment of preventative medications
- acute use of migraine-specific therapy to treat migraines with severe headache pain, not to exceed 10 days / month
