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Headache parkinson's and alzheimer's
Week 4 Pharm lecture
14
Nursing
Undergraduate 3
02/15/2012

Additional Nursing Flashcards

 


 

Cards

Term
Migraines
Definition

Different triggers

Sometimes 1-2 times a month

Term
WORST thing that can be done to treat a migraine:
Definition

Giving opiates!

 

Opiates cause rebound pain

Term
Best practices: Headache
Definition
  • Recognized triggers for the HA
    • Activities
    • Foods
      • alcohol, red wine, cheese, MSG
    • Stress
    • Menstrual cycles
  • Do something about the triggers
    • e.g., migraine "meds" can be contraceptives that interrupt the cycles

 

Term
Recognize onset of headaches:
Definition
  • Visual changes (scotoma) or visual loss
  • Photophobia, phonophobia
  • Nausea
  • Odd head sensations
  • Smell auras
  • Some have TIA-like symptoms (that mimic stroke but resolve within hours)
Term
Migraine meds: evidence shows that OTC works best when:
Definition

Taken early

in a combination of NSAID or ASA and caffeine

(Excedrine migraine)

 

In caffeine-naive patients - can use strong espresso

Term
Ergotamine: indications
Definition

migraine HA

prophylaxis of migrane

alpha adrenergic blocker

Term
Ergotamine: side effects
Definition
  • Nausea
  • peripheral vasoconstriction
  • uterine stimulation w. decreased placental blood flow (abortive)
  • HTN
  • Can trigger MI
  • Chemically related to LSD, so can change neurological status and induce hallucinations
Term
Serotonergic drugs
Definition

"triptans"

Sumitriptan

Solmitriptan

Term
Serotonergic drugs: effect and action
Definition

Effect: stimulate 5-HT receptors on cranial blood vessels

Action: Cranial vasoconstriction, inhibit inflammatory neuropeptides

 

Term
Serotonergics: ADME
Definition

Admin: oral, nasal, injectable forms

Megabolism: peak and t 1/2 depend on agent

 

Term
Serotonergics: Side effects
Definition
  • Nausea/vomiting
  • Weakness, tingling, flushing
  • Can precipitate stroke, cerebral hemorrhage, MI
  • Pain/pressure in chest, neck throat, jaw
    • "heavy arms"
  • Dizziness, drowsiness

Major concern: CV symptoms

Term
Triptans/serotonergics - contraindications
Definition
  • Ischemic heart disease, history of MI
  • Uncontrolled HTN
  • Caution in renal or hepatic dysfunction, CVA
  • Don't give within 24 of ergotamine
  • Potential toxicity when used with common anti-depressants (SSRI's)
    • Serotonin syndrome
    • Prozac, paxil, zoloft, etc.
  • Most are not allowed more than 6 tabs a month
Term
Migraine prevention
Definition
  • Beta blockers and CCB (calcium channel blockers) have efficacy when taken chronically (Prophylactically)
    • Keeps vessels dilated so less vasoactive tendencies
  • Anti-seziure meds
    • Valproic acid / Valproate (Depakote)
    • Topiramate (Topomax)
    • Prevent the generalized depolarization of the cortex that is associated with migraines
  • TCA (tricyclic antidepressants)
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