Neurology Flashcards
what is the primary difference in the medication effect between triptants and gepants/ditans?
gepants and ditans do not cause vascular constriction / have vascular contraindications
what is the first line treatment for acute treatment of mild to moderate migraine?
nsaids
what is the first line abortive treatment for moderate to severe migraine?
triptan
if a patient fails their first trial of triptan medication, what is the next step in abortive treatment?
try another triptan
what does the POUND pneumonic stand for in the diagnosis of migraine?
P - pulsatile
O - one day duration
U - unilateral
N - nausea / vomiting
D - disabling
over what age serves as a potential red flag for new onset or changing headache?
> 50 years old
t/f aspartame has been linked to migraine trigger
true
what validated questionnaire should you use to assess migraine severity?
migraine disability assessment
what questionnaire can be used to assess treatment response in migraine and guide the need for escalation of therapy?
migraine treatment optimization questionnaire
how is medication overuse headache defined in terms of the number of days that abortive therapy is taken?
10 or more days per month of abortive treatment
in the acute treatment of migraine, what medication class can cause chest discomfort, flushing, sweating, nausea and vomiting?
triptan
t/f lasmiditan (reyvow) can cause dizziness, somnolence, sserotonin syndrome, has black box warning, cannot drive for 8 hours following dose and is a schedule V drug
true
when can a dose of triptan be repeated if migraine is still ongoing?
after 2 hours
what is the mechanism of action of gepants such as ubrelvy and nurtec?
calcitonin gene related peptide receptor anatgonists
why is atogepant different than the other cGRP receptor antagonists?
it is approved for prevention only
what is the mechanism of action of ditan medications?
5HT1 receptor agonists - prevent cGRP release from the trigeminal nerve
which class of medications should be used to address the nausea component in acute migraine?
dopamine antagonists
t/f zofran has insufficient evidence in the treatment of nausea during acute migraine
true
what is the definition of satus migranosus?
migraine lasting > 72 hours
t/f greater occipital nerve block can result in pain improvement in acute migraine
true
t/f gepants and ditans have not been approved for use in children
true
which triptan has been approved for use in children 6 and older?
rizatriptan
what is the first line abortive treatment for migraine during pregnancy?
APAP-caffeine combination
what medication is the recommended second line agent for migraine acute treatment during pregnancy?
metoclopramide
