Hedaches Flashcards
For Mild to Moderate pain Migraine Headaches
NSAIDs and ASA
First line. For moderate to severe migraine headaches
Triptans. MOA- vasoconstriction- treats pain and nausea
Caffeine containing products used for migraines should not be used more than….
three days per month
Triptans are CI for….
Heart Disease Hx of stroke Angina Uncontrolled HTN Pregnancy with an SSRI ergots
Ergots for migraine
constrict intracranial blood vessels
inhibits neurogenic inflammation
activity at dopamenic receptors
Ergots CI:
Preg Cat X Not to be used within 24 hours of a triptan heart disease renal failure liver failure uncontrolled HTN
Cluster Headache treatment:
Can use the same as for migraines
if triptans or ergots can’t be used then sandastatin can be
100% O2 at 5-10L/min for 15 minutes
Prophylaxis for migraine
If pt has frequent HA, pain is severe, and medication is being used 2+ times per week, prophylaxis is indicated. BB TCA NSAID CCB anticonvulsants serotonin antagonist
Define migraine HA
common, recurrent, primary headaches of moderate to severe intensity that interfere with normal functioning and are associated with G.I., neurological, and autonomic symptoms.
They are more common in women than men.
Average age of onset is 15 to 35 years old with a peak between the ages of 35 to 45.
Family history is commonly seen.
They are unilateral in nature.
You will frequently see a premonitory symptoms or aura. Premonitory symptoms can include photophobia, hypersomnia, irritability, drowsiness, or appetite changes. These can occur hours to days before the onset of a migraine headache.
Define Cluster HA
Cluster headaches are less common than migraine and tension headaches.
They affect less than 1% of the population and are more common in males than females.
They result from a hypothalamus dysfunction causing disruption of circadian rhythms.
You usually see them at specific times during the sleep wake cycle at night.
The pain is very severe and centers around one eye.
Define tension HA
Tension headache is the most common type of primary headache.
Muscle contraction is the most significant factor that causes pain.
They are characterized by mild to moderate pain, non-pulsatile in nature, and bilateral.
The pain usually radiates from the forehead to the occiput. They are not associated with premonitory symptoms or auras.
They usually develop later in the day and are most commonly seen in adult females.
Beta Blocker for Migraine prophylaxis
propranolol and timolol
can’t use the triptan Riza with propranolol, must use other triptan
CI with pt who have airway disease and conduction issues
CCB for migraine prophylaxis
verapamil is most used. used for intolerance to BB, can take 6-8 weeks to see benefit, helps with pain and aura
2/3rd line
TCA for migraine prophylaxis
Can be used first line
amitriptyline nortriptyline imitripline
not to be used with a triptan- SS
Antiepileptics for migraine prophylaxis
Valproic Acid, topriamate
Preferred agent of BB is not tolerated
Just as beneficial as propranolol
Tension Headache prophylaxis
TCA
