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Pharm I > T3-Analgesics: Headaches-MJ > Flashcards

T3-Analgesics: Headaches-MJ Flashcards

1
Q

What is the most common headache?

A

Tension

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2
Q

What headache is the disabling headache and needs aggressive treatment?

A

Migraine

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3
Q

Migraines cause _____ head pain

A

Throbbing

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4
Q

What percent of migraines are unilateral?

A

60%

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5
Q

What percent of migraines are bilateral?

A

40%

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6
Q

Do migraines cause N/V?

A

Yes

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7
Q

Migraines cause a person to be sensitive to ___ and ___

A

Light and sound

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8
Q

What is the average length of a migraine?

A

24 hours

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9
Q

So why do people get migraines when that is in the brain and the brain doesn’t have pain receptors (you can poke, cut through the brain and no pain)?

A

Vessels and arteries IN THE BRAIN DO have pain receptors

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10
Q

Do migranes cause vasoconstriction or vasodialiaton?

A

Vasodialaton

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11
Q

Do migraines cause inflammation?

A

Yes

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12
Q

What nerve is effected from migraines?

A

Trigeminal

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13
Q

What promotes migraines?

A

CGRP

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14
Q

What surpasses migraines?

A

Serotonin

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15
Q

If we activate ______ receptors, that will depress the migraines.

A

Serotonin 1B,1D receptors

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16
Q

Which migraine medication stops a migraine AFTER it has started?

A

Abortive

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17
Q

What are the 2 migraine specific drugs?

A

Serotonin 1B,1D agonists (triptans)

Ergot alkaloids

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18
Q

What are triptans selective to?

A

Serotonin 1B,1D

19
Q

What nerve does triptans work on?

A

Trigeminal nerve complex

20
Q

The triptans induce _______.

A

Cerebral vasoconstriction

21
Q

What do triptans block?

A

CGRP

22
Q

What are 3 examples of triptans?

A

Sumatriptan
Eletriptan
Rizatriptan

23
Q

What are the side effects of triptans (3)?

A

Vasoconstriction of coronary arteries
Heavy arms and chest pressure
Serotonin syndrome

24
Q

We want triptans to induce _____ vasoconstriction, but the side effects sometimes cause vasoconstriction of ______.

A

We want them to induce CEREBRAL vasoconstriction but a side effect of triptans is causing vasoconstriction of CORONARY ARTERIES

25
Q

Should you take a triptan if you have coronary artery disease or have had a MI? Why or why not?

A

NO! Side effect of triptan is vasoconstriction of coronary arteries !–NOT GOOD

26
Q

Is the triptan side effect of heavy arms and chest pressure something to be concerned with?

A

No, UNLESS there are risk factors for the patient having heart problems

27
Q

Triptans can also cause serotonin syndrome. Is this common or rare?

A

RARE unless taking some other drug that increases serotonin levels

28
Q

What are the 4 big symptoms of serotonin syndrome?

A

Altered mental status
Fever, sweating
Hyperreflexia
Clonus

29
Q

What are three drug classes that would cause too much serotonin when taking with a triptan?

A

MAOI
SSRI
SNRI

30
Q

If you want to take the other abortive migraine specific drug (ergot alkaloid), how long must you wait to take it after taking a triptan?

A

24 hours; ergot alkaloids also increase serotonin so taking it closely after a triptan could cause toxicity

31
Q

Are triptans for prevention of migraines?

A

No

32
Q

How long does it take the triptan to work?

A

1-2 hours

33
Q

If the triptan doesn’t cause relief after 2 hours, can you take another dose?

A

Yes, but only ONE other dose after initial

34
Q

What is important to tell the patient to report if they begin experiencing it?

A

Chest pain, palpitations

35
Q

What is the MOA of ergot alkaloids?

A

Precise mechanism UNKNOWN, but are similar to triptans

36
Q

What are the side effects of ergot alkaloids?

A

N/V (10%)

Ischemia with overdose

37
Q

Why is the side effect of N/V in ergot alkaloids a problem?

A

Because migraines already cause N/V–taking an ergot alkaloid increases N/V even more

38
Q

What are the two ergot alkaloid examples?

A

Ergotamine

Dihydroergotamine

39
Q

What are antiemetics used for?

A

Treating nausea

40
Q

What is the preferred antiemetic?

A

Metoclopramide

41
Q

What does metoclopramide do?

A

Reduces N/V
Reduces gastric stasis caused by attack
Enhances absorption of PO meds

42
Q

Can we give metoclopramide even if the patient does not have N/V?

A

Yes, it increases absorption so it can be given to increse the absorption of the migraine drug

43
Q

What does MOH stand for?

A

Medication overuse headaches

44
Q

What is the main take home message about medication overuse headaches?

A

Take the doses as prescribed!!

A client stops taking the med and it causes their headache, so they then take medication, vicious cycle.

Pharm I (30 decks)

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