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NMT200 > pharm-headaches > Flashcards

pharm-headaches Flashcards

1
Q

5 drug class for symptomatic treatment of headache?

A
  1. analgesic
  2. antiemetics
  3. triptans
  4. ergot derivatives
  5. calcitonin gene-related peptide monoclonal antibodies (CGRP)
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2
Q

3 analgesics used for symptomatic treatment of headache?

A

ibuprofen, naproxen, acetaminophen

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3
Q

1 antiemetic used for symptomatic treatment for headaches?

A

metaclopramide

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4
Q

1 triptans for symptomatic treatment of headache?

A

sumatriptan

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5
Q

Example of an ergot derivative (symptomatic tx)?

A

dihydroergotamine mesylate (DHE)

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6
Q

5 drugs classes used for migraine prophylaxis?

A
  1. B-blocker
  2. TCA
  3. angiotensin II R antagonist
  4. anti epileptics
  5. calcitonin gene-related peptide monoclonal antibodies (CGRP)
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7
Q

What is considered 1st line for symptomatic tx?

A

Consider ASA + NSAIDs (Naproxen, ibuprofen, etc) as 1st line
-have greater efficacy to their anti-inflammatory properties over acetaminophen

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8
Q

analgesic adverse effects?

A
  • Acetaminophen is generally better tolerated but may potentially cause hepatotoxicity w/ chronic use
  • NSAIDs ↑ CVD risk + mortality esp. w/ chronic use + may cause GI upset
  • NSAIDs + acetaminophen should be used less than 15days/ month to minimize the development of medication overuse headache
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9
Q

Triptan?

A

Sumatriptan

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10
Q

CGRP R antagonist for symtomatic use?

A

Ubrogepant

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11
Q

Indication for dihydroergotamine mesylate (ergot derivative)

A

can treat MOH (can also cause)

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12
Q

What drug is similar to triptan but added affinity for dopamine + adrenergic R & thus increase side effect potential?

A

dihydroergotamine mesylate (ergot derivative)

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13
Q

What drug is indicated for migraine attacks?

A

Sumatriptan

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14
Q

What drug is reserved for tx of acute migraine when other drug options have failed?

A

ubrogepant (CGRP R antagonist)

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15
Q

Adverse Effects ⚠️

  • chest pain, tingling, nausea, vomiting, parenthesis, cramps, vasoconstriction occur infrequently + are of short duration
  • may cause hypotension (rare)
  • does not cause dependence but can cause MOH if used 10 days/ month or more
A

dihydroergotamine mesylate (ergot derivative)

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16
Q

Contraindications:
- pregnancy
- cardiac disorders, hypertension, peripheral vascular disorders
- sepsis
- liver disease
- PUD
- renal disease

A

dihydroergotamine mesylate (ergot derivative)

17
Q
  • chest discomfort, fatigue, dizziness, parenthesis, drowsiness, nausea, throat symptoms
  • use less than 10 days/ month to avoid MOH
A

sumatriptan

18
Q

Contraindications:

  • cardiac disorders, sustained hypertension, basilar + hemiplegic migraine
  • Basilar migraines
    • originated in the brainstem + usually have aura w/ dizziness, double vision, lack of coordination prior to onset of pain
  • Hemiplegic migraines
    • rare + mimic strokes
  • Do not use w/ ergotamine-containing products
  • Do not use triptan within 24 hours after another triptan
  • Caution w/ serotonergic meds
    • small ↑ risk of serotonin syndrome
  • Do not use w/ MAOIs
A

sumatriptan

19
Q
  • nausea, somnolence, dry mouth
  • suppression of CGRP may theoretically ↑ risk of serious cardiovascular or cerebrovascular ischemic events

Contraindications:

  • concomitant use of strong CYP3A4 inhibitors
A

ubrogepant (CGRP R Antagonist)

20
Q

Example of B-blocker for prophylatic tx?

A

Propanol
(also metoprolol, nadolol)

21
Q

Example of TCA for prophylatic tx?

A

amitriptyline

22
Q

Example fo an angiotensin R blocker for prophylaxis?

A

Candesartan

23
Q

Examples of anti-epileptics for prophylaxis(4)?

A
  1. Valproic acid
  2. divalproex sodium
  3. topiramate
  4. gabapentin
24
Q

Example of CGRP monoclonal antibodies for prophylaxis?

A

Erenumab

25
Q
  • fatigue, impotence, bradycardia + hypotension GI symptoms, bronchospasm, 🫀failure. depression

Contraindication:
- asthma, insulin dependent-diabetes, 🫀block

A

propanol (b-blocker)

26
Q

Amitriptyline is indicated for?

A

TTH

27
Q

efficacy in migraine prophylaxis due to blocking the direct vasoconstriction, ↑ sympathetic discharge, adrenal medullary catecholamine released mediated by angiotensin II

A

Candesartan (angitoten R blocker)

28
Q

modulate GABA R in trigeminovascular system & are effective in migraine prophylaxis

A

Valproic acid + divalproex sodium
Anti-epileptics

29
Q

What drug is administered by subcutaneous injection and associated w/ 50% reduction in headache and must be used only went 1st line preventative agents have failed?

A

Erenumab (CGRP Monoclonal antibodies)

30
Q

Contraindication ⚠️
- significant cardiac disease, glaucoma, prostate disease, hypotension

A

Amytriptyline (TCA)

31
Q

Adverse effects ⚠️
- lower risk for adverse effects
- hypotension, hyperkalaemia, renal insufficiency, headache, dizziness

A

(candesartan)
Angiotensin R blocker

32
Q

injection site reactions, constipation, muscle spasms, prutius, constipation, hypersensitivity reactions (may occur within minutes or more than 1 week after tx), hypertension

A

Erenumab

33
Q

Preferred drug for pregnancy for acute tx

A

Acetaminophen

34
Q

Preferred drug for children for acute tx?

A

ibuprofen (avoid ASA in under 15)

NMT200 (11 decks)

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