Migraines Flashcards

1
Q

definition of migraine

A

headache lasting 4-72 hours

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2
Q

At least two of these features must occur for diagnosis of migraine

A

–unilateral head pain
–throbbing pain
–worsens with activity
–moderate/severe pain

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3
Q

One of these features must occur for diagnosis of migraine

A

–N/V
–photophobia
–phonophobia

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4
Q

classifications of migraines

A

–aura present
–aura not present
–chronic (15 days/month for 3 months)

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5
Q

risk factors for migraines

A

–family hx
–estrogen and progesterone
–genetic and environmental factors

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6
Q

triggers for migraines

A

–fatigue
–oversleeping
–missed meals
–overexertion
–weather change
–stress
–hormonal changes
–bright lights or strong smells

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7
Q

patho of migraines

A

–change in neurotransmitter levels in CNS
–blood vessel tone
–vasodilation

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8
Q

premonitory phase in migraines

A

1/3 have…
–fatigue
–irritability
–loss of concentration
–stiff neck
–food cravings

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9
Q

migraine aura

A

up to 1/3 have aura symptoms lasting up to 1 hour

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10
Q

headache phase of migraines

A

–throbbing pain
–fatigue, nausea, vomiting, dizziness, hypersensitivity to touch on head
–last 4 to 72 hours

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11
Q

recovery phase of migraine

A

–irritability
–fatigue
–depression

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12
Q

abortive (symptomatic) therapy for migraines

A

–aspirin-like drugs (ASA, acetaminophen, NSAIDs)
–Serotonin Receptor Agonists (triptans) – sumatriptan
–Calcitonin Gene-related Peptide (CGRP) Antagonist

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13
Q

example of serotonin receptor agonist

A

sumatriptan

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14
Q

MOA of sumatriptan

A

–constrict intracranial blood vessels
–suppress release of inflammatory neuropeptides
–block brain pathways for pain

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15
Q

route for sumatriptan

A

–SQ
–PO
–intranasal

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16
Q

side effects of sumatriptan

A

–injection site reaction (SQ)
–chest pressure
–flushing
–weakness
–headache
–bad taste (nasal)

17
Q

how long do side effects of sumatriptan last?

A

about 30 minutes

18
Q

considerations for sumatriptan

A

avoid with ischemic stroke or heart disease and angina

19
Q

example of CGRP antagonist

A

rimegepant (Nurtec)

20
Q

MOA of rimegepant

A

mediates pain transmission

21
Q

route for rimegepant

A

PO

22
Q

side effects for rimegepant

A

GI upset

23
Q

considerations for rimegepant

A

CYP substrate (caution with inhibitors or inducers)

24
Q

preventive therapy for migraines

A

–beta blockers (propanolol)
–tricyclic antidepressants
–antiepileptic drugs (divalproex, topiramate)
–estrogens (menstrual migraine)

25
Q

preventative therapy goals

A

–reduce attack frequency, severity, and duration
–improve responsiveness to treatment of acute attacks
–improve function and reduce disability
–prevent progression or transformation of episodic migraine to chronic migraine