Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Junior - Pharm II - 1 > 4 - Headache > Flashcards

4 - Headache Flashcards

(55 cards)

Start Studying
1
Q

Which type of headaches are described as “pulsating,” and aggravated by physical activity?

A

MIgraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which type of headache presents bilaterally, described as “pressure” or “tightening”, and no nausea?

A

Tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which headache is predominantly found in males, described as severe “boring” or “piercing” pain, and occurs exclusively unilaterally?

A

Cluster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

“SNOOP”ing for secondary headaches:

A 
Systemic symptoms
Neurologic s/s
Onset sudden
Onset late in life
Pattern change
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

“Worst headache of my life” - must r/o:

A

Subarachnoid hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The majority of migraines are with or without aura?

A

Without (85%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Criteria for migraine without aura:

A

At least 5 attacks

Lasts 4-72 hrs untreated

Unilateral

Pulsating

N or V or both

Photophobia

Phonophobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Criteria for migraine headache WITH aura

A

At least 2 attacks

Aura symptom (visual, sensory, speech, motor, retinal)

Aura lasts 5 to 60 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What gene mutation are migraines associated with?

A

CACNL1A4 on chromosome 19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What neurotransmitter is an important mediator of migraines?

A

Serotonin (5-HT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

APAP - use in migraines?

A

May be useful 1st choice drug for acute migraine in those with mild to moderate attacks OR in those with CI’s to NSAIDS / ASA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Butalbital - class?

A

Short acting barbiturate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In which combination is Butalbital a scheduled drug?

A

When combined with ASA and caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Midrin - composed of?

A

APAP
Isometheptene
Dichloralphenazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Midrin - clinical use?

A

Alternative choice for mild to moderate migraine attacks

Controlled (C-IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Midrin - CI’s?

A

Glaucoma
Severe renal or hepatic disease
HTN
MOAI’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What OTC is a reasonable first-line tx for migraine attacks?

A

Excedrin MIgraine (APAP/ASA/caffeine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

NSAID’s - MOA (migraines)

A

Prevents neurogenically mediated inflammation in the trigeminovascular system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is considered the DOC for mild to moderate migraine attacks?

A

NSAID’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which three NSAID’s have the most consistent evidence in the tx of migraine attacks?

A

ASA
Vit-M
Naproxen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ergotamine - MOA:

A

Partial agonist activity at 5HT and D2 alpha-adrenergic receptors

Peripheral and cranial vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ergotamine - pharmacokinetics:

A

Oral absorption is incomplete and erratic - administer with caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ergotamine - AE’s:

Study These Flashcards
A

Ergotism - intense vasoconstriction -> ischemia

24
Q

Ergotamine - pregnancy cat?

Study These Flashcards
A

X - stimulates uterus

25
Ergotamine - drug interactions:
Don’t use within 24 hrs of a triptan Potent CYP3A4 inhibitors
26
When to give Ergotamine?
At the first sign of a migraine attack
27
Dihydroergotamine - MOA:
Similar to ergotamine but with LESS POTENT A1-adrenergic vasoconstriction Less n/v
28
Dihydroergotamine - clinical considerations:
Not for use as a monotherapy Try when first-lines have failed Add anti-emetic as nause/vomiting likely SE
29
Triptans - MOA:
5-HT1B/1D receptor agonist with add’l activity at 5-HT1F receptors Cranial vasoconstriction, peripheral neuronal inhibition, inhibition of trigeminocervical complex
30
Triptans - clinical use:
Appropriate 1st line therapy for moderate to severe migraine
31
Triptans - AE’s:
Chest tightness, pressure, heaviness, or pain Paresthesia, dizziness, somnolence
32
Limit use of triptans to no more than __ days per month
9
33
Triptans - CI’s:
Hx of ischemic heart disease, uncontrolled HTN, stroke
34
Triptans - monitoring:
Pt’s at risk for CAD should have first dose of triptan in the clinic with vitals and ECG monitoring
35
What is the clinic triad of symptoms of serotonin syndrome?
1. Cognitive effects 2. Neuromuscular dysfunction 3. Autonomic dysfunction
36
Sumatriptan/Naproxen (Treximet) - MOA and clinical use:
Targets different vascular and inflammatory processes in a migraine Combination provides superior relief than either component by itself
37
What partial Mu and Kappa agonist can be used off-label as a last resort for migraine tx?
Butorphanol (Stadol)
38
How do antiemetics help with migraines (neuronally):
They act on dopaminergic receptors (antagonist)
39
What is the antiemetic of choice for migraines?
Metoclopramide
40
Strategy to avoid MOH?
Limit migraine therapies to 2 days/week
41
What migraine med is totally contraindicated for pregnancy and breastfeeding?
Ergots
42
Proposed etiology of tension headaches?
Originate from myofascial factors and peripheral sensitization of nociceptors
43
Clinical presentation of tension headache - what makes it different from migraine headaches?
Lacks premonitory symptoms and aura Bilateral, non-pulsatile pressure Disability minor compared to migraine
44
Acute tx of tension HA’s:
APAP/NSAIDS | Muscle relaxants
45
Consider prophylaxis if tension headache frequency is more than __ per week
2
46
What is the tension HA prophylaxis DOC?
Amitriptyline at bedtime
47
What is the most severe of the primary HA’s?
Cluster
48
Typical pt for cluster HA’s:
Male, mid-thirties
49
When do most cluster attacks occur?
At night, in the spring and fall, occurring suddenly, with a rapid crescendo to excruciating pain
50
In order to Dx cluster HA, what must be present?
Ipsilateral symptom (lacrimation, rhinorrhea, eyelid edema, ptosis, etc)
51
What is a standard first line tx for cluster HA’s?
100% O2 via NRB @ 7-10L/min x 15-25mins
52
What Ha medicine is considered first line (after oxygen) for cluster HA’s?
Sumatriptan
53
What is the drug of choice for maintenance prophylaxis of cluster HA’s?
Verapamil (Calan)
54
What is 2nd line prophylaxis for cluster HA’s?
Lithium
55
What is DOC for transitional prophylaxis of cluster HA’s?
Prednisone

Junior - Pharm II - 1 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions