Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pmcol 200 > L21 > Flashcards

L21 Flashcards

1
Q

leading cause of disability worldwide,

particularly in those under 50

A

migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

primary__ disorder
characterized by recurring headaches
that are moderate to severe, pulsating
in nature, last from __hours

A

headache

2-72

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

sensitivity to normal__ input

A

sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

aura

A

precedes migraine - 20%

visual disturbances consisting of flashing lights or zigzag lines moving across the field of vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

migraine risk a mix of__ and__ factors
affects__ more than
men; increase after _

A

genetic environmental
women
puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

familial hemiplegic

migraines

A

weakness of half of the body

autosomal dominant inheritance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

3 known genetic mutations

associated with FHM:

A
  • P/Q-type calcium channel
  • Na+/K+ATPAase
  • Na+ channel subunit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

thought to be driven by cortical

spreading depression:

A 
wave of
neuronal depolarization followed
by desensitization (“depression”)
that propagates across the
cortex)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

mutations lower the threshold for

A

cortical spreading depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Trigeminal nerve is the

A

largest cranial nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Peripheral processes divided into three branches

A
  • ophthalmic, maxillary and mandibular.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q 
3 purposes of Trigeminal System:
‣ Senses _ and _ in
the head region
‣ innervates the _ _
(membrane that surrounds the brain)
‣ controls _ blood vessels
(trigeminovascular system)
A 
‣ Senses pain and temperature in
the head region
‣ innervates the dura mater
(membrane that surrounds the
brain)
‣ controls cerebral blood vessels
(trigeminovascular system)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pain in head detected by _ branch of the _ nerve innervating _ mater and associated blood vessels

A

pain in head detected by ophthalmic branch of the trigeminal nerve innervating dura mater and associated blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

cause of migraine still unknown, but thought to be a__ disease

A

neurovascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why is migiraine thought to be neurovascular disease (3)

  1. _ vessels _ during migraine attack
  2. _ blood vessel stimulation provokes headache
  3. _ drugs alleviate pain
A
  1. extracerebral vessels dilate during migraine attack
  2. cranial blood vessel stimulation provokes headache
  3. vasoconstrictor drugs alleviate pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

release of 5-HT leads to

A

vasoconstriction

17
Q

low _ levels in migraineurs_ attacks

A

5-HT

between

18
Q

5-HT is released_ migraine attacks

A

during

19
Q

Calcitonin gene-related peptide (CGRP) located in

Released from_ in response to_, leads to_

elevated/decreased in those with migraine

A

trigeminal peripheral afferents.

afferents, pain, vasodilation

elevated

20
Q

Treatment strategies incorporates both _ and_ strategies

A

prophylactic

abortive

21
Q

Prophylactic treatments are taken_ to_ attacks,

abortive treatments taken__ an attack_

A

daily, prevent

once, occurs

22
Q

Non-pharmacological Interventions:

A

Identify triggers (Diet, exercise, consistent sleep, avoiding excessive caffeine and alcohol, minimize stress).

23
Q 
prophylactic Pharmacological Interventions: 
Beta blockers (_), anticonvulsants (_), antidepressants (_)
A

Beta blockers (propanolol) - decrease BP, anticonvulsants (gabapentin) - block pain, antidepressants (amitriptyline) - SSRI by blocking SERT

24
Q

abortive pmcol interventions
Non-specific analgesics (,,,)
risk of

A

asprin, acetaminophen, NSAID, opioids

medication overuse headache

25
Q

caffeine is an __ receptor antagonist
• leads to __
• __ absorption of some __
(acetominophen, ergotamines)
• improves migraine treatment during attack
• but may also trigger __ or result in __ headache (withdrawal)

A

caffeine is an adenosine receptor antagonist
• leads to vasoconstriction
• increases absorption of some analgesics
(acetominophen, ergotamines)
• improves migraine treatment during attack
• but may also trigger headaches or result in rebound headache (withdrawal)

26
Q

ergot alkaloid (like LSD)
• first __ anti-migraine agents (introduced in 1926), but no longer first line therapy
• agonists for ___receptors that inhibit neurogenic ___
• but, low degree of receptor ___ which increases the risk of experiencing a drug-induced __ __

A 
ergot alkaloid (like LSD)
• first specific anti-migraine agents (introduced in 1926), but no longer first line therapy
• agonists for 5HT-1b/d receptors that inhibit neurogenic inflammation
• but, low degree of receptor selectivity which increases the risk of experiencing a drug-induced side effect
27
Q

Ergotamine can produce coronary ___, often with associated ___ changes and __ pain in patients with coronary artery disease.
• Contraindicated in patients with __ vascular disease, coronary heart disease, uncontrolled hypertension, stroke

A

Ergotamine can produce coronary vasoconstriction, often with associated ischaemic changes and anginal pain in patients with coronary artery disease.
• Contraindicated in patients with peripheral vascular disease, coronary heart disease, uncontrolled hypertension, stroke

28
Q

Ergotamines Absorption+Distribution: Large first pass metabolism via ___ administration leads to ___ bioavailability (<1%), caffeine can improve both __ and __ of absorption

A

Large first pass metabolism via oral administration leads to low bioavailability (<1%), caffeine can improve both rate and extent of absorption

29
Q

Ergotamines

Metabolism: metabolized by __ by poorly defined enzymes. Half life is __hours

A

Metabolism: metabolized by liver by poorly defined enzymes. Half life is 2hours

30
Q

Ergotamines

Excreted in__

A

bile

31
Q 
Triptans
first line migraine therapy (i.e. \_\_\_)
•selective 5-HT1b/d \_\_\_
•two mechanisms: \_\_\_ and inhibition of \_\_\_ nerve
•avoids many of the side effects of \_\_
A

first line migraine therapy (i.e. Sumatriptan)
•selective 5-HT1b/d agonist
•two mechanisms: vasoconstriction and inhibition of trigeminal nerve
•avoids many of the side effects of ergotamine

32
Q

Sumatriptan
• Absorption+Distribution: Bioavailability around __% when taken orally, __% when given subcutaneously (because first pass metabolism)
• Metabolism: metabolized by __ __ in the liver to __ acid. Half life around _hours.
• Excretion: Cleared in the __.

A
  • Absorption+Distribution: Bioavailability around 14% when taken orally, 96% when given subcutaneously (because first pass metabolism)
  • Metabolism: metabolized by monoamine oxidase in the liver to indoleacetic acid. Half life around 2 hours.
  • Excretion: Cleared in the urine.
33
Q

CGRP Antagonists
small molecule CGRP __
• __ __s to CGRP or CGRP receptor
• several potential drug candidates have been developed and currently under investigation

A

small molecule CGRP antagonists
• monoclonal antibodies to CGRP or CGRP receptor
• several potential drug candidates have been developed and currently under investigation

34
Q

CGRP Antagonists
BIBN4096 (__)
• Good __ at treating migraine
• __ bioavailability (particularly orally) which limited clinical efficacy. Abandoned at Phase __ clinical trial.

A

BIBN4096 (Olcegepant)
• Good efficacy at treating migraine
• Poor bioavailability (particularly orally) which limited clinical efficacy. Abandoned at Phase II clinical trial.

35
Q

CGRP Antagonists
MK-0974 (__)
• several Phase __ clinical trials support anti-migraine efficacy and safety
• problems emerged with __ dosing (elevation of liver __). Abandoned at Phase __ Clinical Trial.

A

MK-0974 (Telcagepant)
• several Phase III clinical trials support anti-migraine efficacy and safety
• problems emerged with daily dosing (elevation of liver aminotransferase). Abandoned at Phase III Clinical Trial.

36
Q

CGRP Antagonists
Rimegepant (Nurtek) is one of the few remaining small molecule CGRP receptor antagonists that remains in clinical development
• __ migraine treatment
• less effect on __ levels (safer for longterm use)

A

Rimegepant (Nurtek) is one of the few remaining small molecule CGRP receptor antagonists that remains in clinical development
• effective migraine treatment
• less effect on liver aminotransferase levels (safer for longterm use)

Pmcol 200 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions