Drugs for Headaches Lecture PDF Flashcards

1
Q

Principles of migraine headache treatment (2)

A
  • Management at abortive or symptomatic therapy of onset attack
  • prevention of attack all together
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2
Q

Drug of choice in mild migraine, moderate, and severe

A
  • nonopiod analgesic (NSAIDs, excedrin migraine (ibuprofen+caffeine)
  • triptans
  • opioid
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3
Q

Excedrin migraine content, clinical usefulness

A
  • Acetaminophen, aspirin, caffeine

- readily effective in studies

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4
Q

Theories to how NSAIDs alleviate migraine pain (3)

A
  • inhibition of PG synthesis
  • blocking platelet aggregation
  • reducing serotonin release
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5
Q

Indomethacin

A

AVOID it regarding migraine treatment because it causes headaches

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6
Q

Injectable ketorolac function

A

highly useful in resolving nausea and vomiting in migraine patients

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7
Q

Serotonin 1B/1D receptor agonists (triptans) function, mech of action, ADR’s (3), drug interactions

A
  • Allow for relief generally 60 minutes after administration
  • analogue of serotonin that stimulates receptor subtypes causing vasoconstriciton of intracranial blood vessels
  • Chest pain, coronary vasospasm (contraindicated in CAD patients), vertigo
  • MAOI’s increase half life, SSRI’s can lead to serotonin syndrome
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8
Q

Ergotamine function, mech of action, ADR’s (2)

A
  • Used to stop an ongoing migraine attack and to treat cluster headaches not to be used on a long term basis (especially not daily)
  • Direct vasoconstrictor of smooth muscle in cranial blood vessels and an agonist at serotonin receptors
  • Ergotism (headache, NVD, gangrene of fingers and toes), Ischemia resulting in cold limbs and potential gangrene
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9
Q

dihydrogotamine function, contraindications (2)

A
  • Nonsedating serotonin agonist used as DOC for terminating severe refracatory migraine and cluster headaches and provides minimal peripheral vasoconstriction and little physical dependence (unlike ergotamine)
  • CAD, peripheral vascular disease
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10
Q

butorphanol nasal spray function, administration, ADR’s (2)

A
  • An opioid agonist-antagonist nasal spray effective for relief of moderate to severe migraine
  • One spray in one nostril, another in the other following 60 min, same 2 dose sequence repeated next 3-5 min
  • Syncope, respiratory depression
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11
Q

Butterbur

A

Extract supplement given prophylactically in migraine patients that has been shown to have a 50% reduction or greater in headaches, can cause mild GI upset as common side effect

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