T3-Analgesics: Headaches-MJ Flashcards Preview

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

Flashcards in T3-Analgesics: Headaches-MJ Deck (44):
1

What is the most common headache?

Tension

2

What headache is the disabling headache and needs aggressive treatment?

Migraine

3

Migraines cause _____ head pain

Throbbing

4

What percent of migraines are unilateral?

60%

5

What percent of migraines are bilateral?

40%

6

Do migraines cause N/V?

Yes

7

Migraines cause a person to be sensitive to ___ and ___

Light and sound

8

What is the average length of a migraine?

24 hours

9

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)?

Vessels and arteries IN THE BRAIN DO have pain receptors

10

Do migranes cause vasoconstriction or vasodialiaton?

Vasodialaton

11

Do migraines cause inflammation?

Yes

12

What nerve is effected from migraines?

Trigeminal

13

What promotes migraines?

CGRP

14

What surpasses migraines?

Serotonin

15

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

Serotonin 1B,1D receptors

16

Which migraine medication stops a migraine AFTER it has started?

Abortive

17

What are the 2 migraine specific drugs?

Serotonin 1B,1D agonists (triptans)
Ergot alkaloids

18

What are triptans selective to?

Serotonin 1B,1D

19

What nerve does triptans work on?

Trigeminal nerve complex

20

The triptans induce _______.

Cerebral vasoconstriction

21

What do triptans block?

CGRP

22

What are 3 examples of triptans?

Sumatriptan
Eletriptan
Rizatriptan

23

What are the side effects of triptans (3)?

Vasoconstriction of coronary arteries
Heavy arms and chest pressure
Serotonin syndrome

24

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

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

25

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

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

26

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

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

27

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

RARE unless taking some other drug that increases serotonin levels

28

What are the 4 big symptoms of serotonin syndrome?

Altered mental status
Fever, sweating
Hyperreflexia
Clonus

29

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

MAOI
SSRI
SNRI

30

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?

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

31

Are triptans for prevention of migraines?

No

32

How long does it take the triptan to work?

1-2 hours

33

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

Yes, but only ONE other dose after initial

34

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

Chest pain, palpitations

35

What is the MOA of ergot alkaloids?

Precise mechanism UNKNOWN, but are similar to triptans

36

What are the side effects of ergot alkaloids?

N/V (10%)
Ischemia with overdose

37

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

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

38

What are the two ergot alkaloid examples?

Ergotamine
Dihydroergotamine

39

What are antiemetics used for?

Treating nausea

40

What is the preferred antiemetic?

Metoclopramide

41

What does metoclopramide do?

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

42

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

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

43

What does MOH stand for?

Medication overuse headaches

44

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

Take the doses as prescribed!!

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