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Flashcards in headache 5 Deck (22)
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1

what is the role of opiate analgesics in headache treatment

"rescue therapy" usually used when others have failed

2

what are 2 issues with opiate analgesic use for headaches

1. rebound headache
2. dependence

3

what are 3 ways antiemetics help for migraine treatment

1. helps with nausea associated with migraine
2. nausea associated with medication
3. refractory headache relief

4

what type and specific drugs are the antiemetics used for migraines

Dopamine agonists:
1. metoclopramide
2. chlorpromazine
3. prochlorperazine

5

what antiemetics are no good for treating headaches

serotonin agents (ondansetron...)

6

what is contained in Treximet

sumatriptain and naproxen

7

what are the acute migraine management goals (6)?

1. treat attacks rapidly and consistently without recurrence
2. restrore patients ability fo function
3. minimize use of rescue meds
4. optimize self care
5 cost effective
6. minimal or no adverse effects

8

when should non-oral route be selected for migraine management

if migraines present with nausea or vomiting

9

acute migraine therapy should be limited to how often

2-3 days per week

10

selection of migraine therapy should be based on what?

1. level of evidence
2. comorbid conditions
3. side effect profile
4. drug interactions

11

what beta blockers can be used to treat migraines

1. propranolol
2. timolol (eye drops)
3. metoprolol

12

what type beta blockers are not effective for migraines?

Intinsic symptathomimetic activity (ISA).

13

betablockers are preferred in patients with what 3 concamittant conditions

1. angina
2. hypertension
3. anxiety

14

if someone has heart failure and migraines, what is the best drug to pick

metoprolol

15

what tricyclic antidepressant is used for headaches?

amitriptyline

16

how does amitriptyline work to relieve headaches?
what are its main side effects?

down regulation of serotonin receptors
1. anticholinergic
2. cardiac
3. sedation

17

what SSRI can be used to treat migraines

none; can worsen it

18

what anticonvulsants can be used to treat migraines

1. Depakote
2. topiramate
3. carbamazepine (not as often)

19

what is the biggest side effect seen with topiramate

memory difficulties

20

when are NSAIDs to be taken for best treatment of migraines

1-2 days before a predictable pattern headache

21

how long does it take for verapamil (CCBs) effect to be seen on migraines

8 weeks

22

what are some natural migraine remedies with evidence indicating they are effective

1. butterbur
2. riboflavin
3. Co-Q 10
4. botulism toxin injections