Flashcards in Pharm for HA, Cohen Deck (45)
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1
chronic pain
continuing pain >6 mo
2
patients with headaches need what besides pain relief
explanation for the HA
3
Treatment for HA depends on
frequency attacks and severity
presence and degree of disability
assoc symptoms
prior response to meds
comorbid and coexistant conditions
4
migraine criteria
>5 attacks lasting 4-72 hours
>2: unilateral, pulsating, mod-severe, aggravated by routine activity
>1: nausea and/or vomiting
photophobia and phonophobia
no evidence on Hx or examination of disease that may cause HA
5
Tx of migraine attacks
OTC meds
migraine specific meds from doc
caffeine, including dark chocolate or cola drinks
getting some sleep
6
when are triptans taken usualy
few hours after begining of migraine
7
what R do triptans work on
5GT1B 1D and1F
8
what newer triptans have better effect and fewer side effects
rizatriptan
electriptan
9
CI triptans
coronary artery disease of cerebral vascular disease
10
half life triptans
<4 hours
11
what medicaiton for HA can increase BP
ergotamine
12
what is a drug used IV or IM for migraines acutely
dihydroergotamine DHE
13
half life DHE
9 hours
14
what dopamine blockers are used for migraine
haloperidol
15
what drug is common in ED for migraine to avoid opioid use
antihistamine
16
future of migraine medication
long acting monoclonal Ab to CGRP
for preventative migraines
17
when do we start Txing prophylactically for migraines
when patient cannot go a week between migraines
insufficient relief from abortives
18
what are great preventative migraine meds and what do they have in common
amitriptyline, propanolol, topiramate
Na channel blockers!
19
what are good preventative migraine drugs
gabapentin, zonisamide
20
which drugs are FDA approved for migraine prevention
propanolol, topiramate
valproic acid
21
half life propanolol
4-6 hours
needs to be taken 3x day
there are long acting formulations
22
CI propanolol
relative in asthmatics or CHF or bradycardia from heart blocks
23
effects amitryptyline
antihistamine
very anticholinergic!
24
dosing amitriptyline
low dosese in evening
25
side effects amitriptyline
tachyarrhythmias
can cause suicide from overdose
weight gain
26
topiramate is FDA approved for what
prevention seizures and migrains
27
half time topriamate
18-20 hours
take at bedtime
28
side effects topiramate
"dopamax" because can cause difficulties with speech and cognition
anorexia and weight loss
loss of sensation in arms
changes in serum acidity and Ca solubility
29
MOA valproic acid
blocking Na Ch and effects of gamma aminobutyric acid
30