Pharm 9 Headache Flashcards
Prolongued use of acute Tx
Leads to daily headache that doesn’t respond to preventative therapy
NSAIDs
For mild episodes without nausea or need for bed rest
Combination analgesics
Aspirin, acetaminophen, cafeine
-Metoclopramide-
Antiemetic
5HT agonist
D2 antagonist
-Butorphanol-
Opioid nasal spray
Opioid + NSAID
-Tramadol & Acetaminophen-
Be wary of addiction potential
-Dexamethasone-
Corticosteroid
Reduces recurrence, not acute pain
-Reserpine-
Triggers migraine
-Sumatriptan-
5HT agonist
Ergot alkaloids
Fungal derivative
Vasoconstrictors
Nonspecific 5HT & Alpha agonists
Ergot CI
Triptans
Ergotamine SE
Severe vasoconstriction
Nausea & vomiting
Dihydroergotamine
Safer than Ergotamine
-Triptans-
MOA
5HT-1 agonists
Triptans with longer half life
Naratriptan
Frovatriptan
Triptan Contraindications
Preexisting HTN
Ergotamine
MAOI
Indication for preventative therapy
> 2 bad headaches per month
-Valproate-
Indication
MOA
Prophylaxis
Anticonvulsant (Enhance GABA)
SSRIs
Not effective at preventing migrane
-Amitriptyline-
TCA
Block NE & 5HT reuptake
-Nortriptyline-
TCA
Block NE & 5HT reuptake
-Propranolol & Timolol-
B Blockers
Prophylaxis
-Verapamil-
Calcium Channel Blocker
Low efficacy for migraine, can’t use with BB, Ergot, Triptan
-Methylsergide-
5HT2 antagonist
High efficacy for migraine Tx