PHARM - headache Flashcards Preview

SBM neurology > PHARM - headache > Flashcards

Flashcards in PHARM - headache Deck (18):
1

trigeminal nerves release what substances antidromically, related to cortical spreading depression?

- CGRP
- substance P
- neurokinin A

2

non-specific acute NSAID treatment options for migraine

- aspirin
- acetominophen
- caffeine
- naproxen
- ibuprofen

3

risk of opioids in migraine treatment

- addiction/rebound
- patient now refractory to other treatment because glutamate is left in the synapse

4

where do ergots come from?

- claviceps purpurea - rye fungus

5

ergots caution

- pregnancy
- CAD

6

ergots and triptan mechanism

- activate receptors broadly
- inhibit neurogenic inflammation (agonists at 5-HT1B "blood vessels" and G-HT1D "nerve terminals")

7

triptans caution

- CAD
- stroke

8

triptan pharm

Sumatriptan 2 2.5 15%
Zolmitriptan 3 2.5 40%
Naratriptan 6 3-4 70%
Rizatriptan 2 1-1.5 40%
Eletriptan 4-5 2.8 50%
Frovatriptan 25 3 30%
Almotriptan 3.5 1.5? 70%

9

triptans safe with MAOIs

naratriptan
almotriptan
eletriptan
frovatriptan

FANE

10

what triptan's levels are raised by propranolol?

rizatriptan

11

what triptans could present a problem in liver failure?

eletriptan
zolmitriptan
EZ

12

good and bad times for b-blockers in prevention of migraine

good - MVP, HTN, anxiety, tremor
bad - depression, reynaud's, fibromyalgia, asthma

13

which antidepressant has the best data for migraine prevention? when is it best used?

amitriptyline
- sleep disturbance, neck pain

14

treatment of cluster headache

- lithium
- sumatriptan
- oxygen
- lidocaine or zolmitriptan intranasaly
- DHE IV

15

best preventer of cluster headaches

verapamil
methysergide

16

prophylactic migraine in pregnancy

- avoid if possible
- verapamil, propranolol

17

migraine treatment in pregnancy

- NSAIDs until week 32
- steroids
- metoclopramide, magnesium

18

mechanism of botulinum toxin in migraine treatment

- binds cholinergic nerve terminals
- cleaves SNAP-25, prevents release of ACh