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Pharmacology > Unit 3-Headache > Flashcards

Unit 3-Headache Flashcards

1
Q

Aspirin, acetaminophen, naproxen, indomethacin, piroxicam, diclofenac, ibuprofen

Drug class

A

Analgesic NSAIDS

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2
Q

Aspirin, acetaminophen, naproxen, indomethacin, piroxicam, diclofenac, ibuprofen

Mechanism

A

Inhibition of COX-1 and COX-2

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3
Q

Aspirin, acetaminophen, naproxen, indomethacin, piroxicam, diclofenac, ibuprofen

Uses

A

Acute treatment of moderate migraines; acute treatment of tension headaches

Excedrin (combination of aspirin, acetaminophen, and caffeine) is particularly effective

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4
Q

Aspirin, acetaminophen, naproxen, indomethacin, piroxicam, diclofenac, ibuprofen

Side effects

A

GI disturbances

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5
Q

Butalbital

Drug class

A

Barbiturate

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6
Q

Butalbital

Uses

A

Acute treatment of migraines; use when more traditional therapies unavailable or contraindicated

Use limited to 2-3 times per week

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7
Q

Butalbital

Side effects

A

Drowsiness, dizziness

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8
Q

Codeine, meperidine, oxycodone, butorphanol, others

Drug class

A

Opioids

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9
Q

Codeine, meperidine, oxycodone, butorphanol, others

Uses

A

Acute treatment of migraines; patients with infrequent headaches; generally, for patients who wake up with a headache

Use less than 2 days per week; pregnant women may use codeine or meperidine with caution

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10
Q

Codeine, meperidine, oxycodone, butorphanol, others

Side efects

A

Drowsiness, constipation, respiratory depression, itching, miosis, urinary retention, euphoria

Physical dependence w/ chronic use.

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11
Q

Prednisone; dexamethasone

Drug class

A

Corticosteroids

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12
Q

Prednisone; dexamethasone

Uses

A
  • Acute treatment of migraines;
  • migraine, prolonged headache syndromes (e.g., status migrainosus);
  • rescue treatment of cluster headache
  • Avoid chronic use
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13
Q

Ergotamine

Drug class

A

Ergot alkaloid

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14
Q

Ergotamine

Mechanism

A

Vasoconstriction possibly; may also act as a 5HT agonist in trigeminovascular pathway

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15
Q

Ergotamine

Uses

A

acute treatment of migraines

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16
Q

Ergotamine

Side effects

A
  • Nausea, dizziness, paresthesia, chest pain, abdominal cramps
  • Contraindicated in women planning pregnancy, uncontrolled HTN, sepsis, renal or hepatic failure, vascular disease
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17
Q

Dihydroergotamine (DHE)

Drug class

A

ergot alkaloid

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18
Q

Dihydroergotamine (DHE)

Mechanism

A

Vasoconstriction possible; mainly act as a 5HT agonist in trigeminovascular pathway

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19
Q

Dihydroergotamine

Uses

A
  • Acute treatment of migraines;
  • less likely to cause rebound headache than ergotamine;
  • acute treatment of cluster headaches;
  • short-term prevention of cluster headaches (along with steroids)
  • injectable
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20
Q

Dihydroergotamine (DHE)

Side effects

A
  • Nausea (less likely than ergotamine), dizziness, paresthesia, chest pain, abdominal cramps
  • Contraindicated in women planning pregnancy, uncontrolled HTN, sepsis, renal or hepatic failure, vascular disease;
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21
Q

Sumatriptan and 6 others

Drug class

22
Q

Sumatriptan and others

Mechanism

A

Selective 5HT1b-d agonists; penetration of CNS, constriction of extracerebral intracranial vessels, inhibition of trigeminovascular system

23
Q

Sumatriptan and others

Uses

A

Acute treatment of migraines (premier option); also effective for photo/phonophobia, nausea and vomiting; acute treatment of cluster headaches

(Sumatriptan is injectable)

24
Q

Sumatriptan and others

Side effects

A

Flushing, tingling, dizziness, chest discomfort (noncardiac)

Contraindicated in vascular disease (including Prinzmetal), uncontrolled HTN, complicated migraine; injectable (suma)

25
Onabotuilnum Toxin A Mechanism
Unknown (possibly decreased afferent stimulation of trigeminovascular system, or downregulation of sensory and parasympathetic receptors)
26
Onabotulinum Toxin A Uses
Preventive treatment of chronic migraine headaches FDA approved specific injection site protocol followed.
27
Onabotulinum Toxin A Side effects
Injection site pain, headache, neck weakness, ptosis
28
Amitriptyline, protriptyline, nortriptyline Class
Tri-cyclic antidepressants (TCA)
29
Amitriptyline, protriptyline, nortriptyline Uses
Migraine prevention, tension headache prevention
30
Amitriptyline, protriptyline, nortriptyline Side effects
Dry mouth, constipation, weight gain, cardiac toxicity, orthostatic hypotension
31
Fluoxetine, paroxetine, sertraline Class
SSRIs
32
Fluoxetine, paroxetine, sertraline Uses
Migraine prevention, tension headache prevention; treatment for coexistant depression and chronic daily headache
33
Fluoxetine, paroxetine, sertraline Side effects
Weight gain, sexual dysfunction, headache
34
Propranolol, timolol, nadolol, atenolol Class
Beta blockers
35
Propranolol, timolol, nadolol, atenolol Uses
Migraine prevention [Only propranolol and timolol FDA approved, but nadolol and atenolol sometimes preferred for their longer half-life and tolerability.]
36
Propranolol, timolol, nadolol, atenolol Side effects
Drowsiness, depression, decreased libido, hypotension, memory disturbance Contraindicated in asthma, diabetes, CHF, or Raynaud's
37
Verapamil Class
Calcium Channel Blockers
38
Verapamil Uses
Migraine prevention; particularly useful in prolonged or disabling aura, or complicated migraine syndromes (e.g., hemiplegic migarine); long-term prevention of cluster headaches
39
Verapamil Side effects
Constipation, dizziness
40
Valproic acid Class
antiepileptic
41
Valproic acid Uses
Migraine prevention
42
Valproic Acid Side effects
Hepatotoxicity, pancreatitis, blood dyscrasias, sedation, hair loss, weight gain, tremor, decreasing cognition
43
Topiramate Class
Antiepileptic
44
Topiramate Uses
Migraine prevention
45
Topiramate Side effects
Hepatotoxicity, pancreatitis, blood dyscrasias, sedation, hair loss, weight loss, tremor, decreasing cognition acute angle-closure glaucoma
46
Oxygen Uses
Acute treatment of cluster headaches
47
Oxygen Side effects
Rebound can occur when oxygen stopped
48
Lithium Mechanism
Alters circadian rhythm (?)
49
Lithium Uses
Cluster headache prevention
50
Lithium Side effects
Weakness, nausea, thirst, tremor, lethargy, blurred vision & slurred speech Confusion, nystagmus Must monitor blood levels; do not use with indomethacin or Na-depleting diuretics

Pharmacology (26 decks)

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