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Pharmacology > Unit 3-Headache > Flashcards

Unit 3-Headache Flashcards

1
Q

Aspirin, acetaminophen, naproxen, indomethacin, piroxicam, diclofenac, ibuprofen

Drug class

A

Analgesic NSAIDS

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2
Q

Aspirin, acetaminophen, naproxen, indomethacin, piroxicam, diclofenac, ibuprofen

Mechanism

A

Inhibition of COX-1 and COX-2

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3
Q

Aspirin, acetaminophen, naproxen, indomethacin, piroxicam, diclofenac, ibuprofen

Uses

A

Acute treatment of moderate migraines; acute treatment of tension headaches

Excedrin (combination of aspirin, acetaminophen, and caffeine) is particularly effective

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4
Q

Aspirin, acetaminophen, naproxen, indomethacin, piroxicam, diclofenac, ibuprofen

Side effects

A

GI disturbances

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5
Q

Butalbital

Drug class

A

Barbiturate

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6
Q

Butalbital

Uses

A

Acute treatment of migraines; use when more traditional therapies unavailable or contraindicated

Use limited to 2-3 times per week

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7
Q

Butalbital

Side effects

A

Drowsiness, dizziness

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8
Q

Codeine, meperidine, oxycodone, butorphanol, others

Drug class

A

Opioids

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9
Q

Codeine, meperidine, oxycodone, butorphanol, others

Uses

A

Acute treatment of migraines; patients with infrequent headaches; generally, for patients who wake up with a headache

Use less than 2 days per week; pregnant women may use codeine or meperidine with caution

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10
Q

Codeine, meperidine, oxycodone, butorphanol, others

Side efects

A

Drowsiness, constipation, respiratory depression, itching, miosis, urinary retention, euphoria

Physical dependence w/ chronic use.

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11
Q

Prednisone; dexamethasone

Drug class

A

Corticosteroids

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12
Q

Prednisone; dexamethasone

Uses

A
  • Acute treatment of migraines;
  • migraine, prolonged headache syndromes (e.g., status migrainosus);
  • rescue treatment of cluster headache
  • Avoid chronic use
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13
Q

Ergotamine

Drug class

A

Ergot alkaloid

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14
Q

Ergotamine

Mechanism

A

Vasoconstriction possibly; may also act as a 5HT agonist in trigeminovascular pathway

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15
Q

Ergotamine

Uses

A

acute treatment of migraines

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16
Q

Ergotamine

Side effects

A
  • Nausea, dizziness, paresthesia, chest pain, abdominal cramps
  • Contraindicated in women planning pregnancy, uncontrolled HTN, sepsis, renal or hepatic failure, vascular disease
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17
Q

Dihydroergotamine (DHE)

Drug class

A

ergot alkaloid

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18
Q

Dihydroergotamine (DHE)

Mechanism

A

Vasoconstriction possible; mainly act as a 5HT agonist in trigeminovascular pathway

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19
Q

Dihydroergotamine

Uses

A
  • Acute treatment of migraines;
  • less likely to cause rebound headache than ergotamine;
  • acute treatment of cluster headaches;
  • short-term prevention of cluster headaches (along with steroids)
  • injectable
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20
Q

Dihydroergotamine (DHE)

Side effects

A
  • Nausea (less likely than ergotamine), dizziness, paresthesia, chest pain, abdominal cramps
  • Contraindicated in women planning pregnancy, uncontrolled HTN, sepsis, renal or hepatic failure, vascular disease;
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21
Q

Sumatriptan and 6 others

Drug class

A

Triptans

22
Q

Sumatriptan and others

Mechanism

A

Selective 5HT1b-d agonists; penetration of CNS, constriction of extracerebral intracranial vessels, inhibition of trigeminovascular system

23
Q

Sumatriptan and others

Uses

A

Acute treatment of migraines (premier option); also effective for photo/phonophobia, nausea and vomiting; acute treatment of cluster headaches

(Sumatriptan is injectable)

24
Q

Sumatriptan and others

Side effects

A

Flushing, tingling, dizziness, chest discomfort (noncardiac)

Contraindicated in vascular disease (including Prinzmetal), uncontrolled HTN, complicated migraine; injectable (suma)

25
Q

Onabotuilnum Toxin A

Mechanism

A

Unknown (possibly decreased afferent stimulation of trigeminovascular system, or downregulation of sensory and parasympathetic receptors)

26
Q

Onabotulinum Toxin A

Uses

A

Preventive treatment of chronic migraine headaches

FDA approved specific injection site protocol followed.

27
Q

Onabotulinum Toxin A

Side effects

A

Injection site pain, headache, neck weakness, ptosis

28
Q

Amitriptyline, protriptyline, nortriptyline

Class

A

Tri-cyclic antidepressants (TCA)

29
Q

Amitriptyline, protriptyline, nortriptyline

Uses

A

Migraine prevention, tension headache prevention

30
Q

Amitriptyline, protriptyline, nortriptyline

Side effects

A

Dry mouth, constipation, weight gain, cardiac toxicity, orthostatic hypotension

31
Q

Fluoxetine, paroxetine, sertraline

Class

A

SSRIs

32
Q

Fluoxetine, paroxetine, sertraline

Uses

A

Migraine prevention, tension headache prevention; treatment for coexistant depression and chronic daily headache

33
Q

Fluoxetine, paroxetine, sertraline

Side effects

A

Weight gain, sexual dysfunction, headache

34
Q

Propranolol, timolol, nadolol, atenolol

Class

A

Beta blockers

35
Q

Propranolol, timolol, nadolol, atenolol

Uses

A

Migraine prevention [Only propranolol and timolol FDA approved, but nadolol and atenolol sometimes preferred for their longer half-life and tolerability.]

36
Q

Propranolol, timolol, nadolol, atenolol

Side effects

A

Drowsiness, depression, decreased libido, hypotension, memory disturbance

Contraindicated in asthma, diabetes, CHF, or Raynaud’s

37
Q

Verapamil

Class

A

Calcium Channel Blockers

38
Q

Verapamil

Uses

A

Migraine prevention; particularly useful in prolonged or disabling aura, or complicated migraine syndromes (e.g., hemiplegic migarine); long-term prevention of cluster headaches

39
Q

Verapamil

Side effects

A

Constipation, dizziness

40
Q

Valproic acid

Class

A

antiepileptic

41
Q

Valproic acid

Uses

A

Migraine prevention

42
Q

Valproic Acid

Side effects

A

Hepatotoxicity, pancreatitis, blood dyscrasias, sedation, hair loss, weight gain, tremor, decreasing cognition

43
Q

Topiramate

Class

A

Antiepileptic

44
Q

Topiramate

Uses

A

Migraine prevention

45
Q

Topiramate

Side effects

A

Hepatotoxicity, pancreatitis, blood dyscrasias, sedation, hair loss, weight loss, tremor, decreasing cognition

acute angle-closure glaucoma

46
Q

Oxygen

Uses

A

Acute treatment of cluster headaches

47
Q

Oxygen

Side effects

A

Rebound can occur when oxygen stopped

48
Q

Lithium

Mechanism

A

Alters circadian rhythm (?)

49
Q

Lithium

Uses

A

Cluster headache prevention

50
Q

Lithium

Side effects

A

Weakness, nausea, thirst, tremor, lethargy, blurred vision & slurred speech

Confusion, nystagmus

Must monitor blood levels; do not use with indomethacin or Na-depleting diuretics

Pharmacology (26 decks)

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