Term
| use an indivudal approach absed on-2 |
|
Definition
|
|
Term
| acute tx should provide-2 |
|
Definition
| rapid relief, return to normal acitvites |
|
|
Term
|
Definition
| reduce frequency, severity, adn disability |
|
|
Term
| the big consequence of using antimigraine meds is- |
|
Definition
| medicaiton overuse headache/rebound headache |
|
|
Term
| 6 classes of drugs for prophylaxis of migraine |
|
Definition
b blocker
NSAID
anticonvulsant
tca
miscellaneous agents
physical activity` |
|
|
Term
| non specific tx for acute episode of migraines-2` |
|
Definition
|
|
Term
| tx for specific tx for acute migraine-2 |
|
Definition
|
|
Term
| analgeisc and NSAIDS can be used for what severity of attacks? |
|
Definition
|
|
Term
| MOA of NSAIDS and analgeisc on migraines |
|
Definition
| inhibit prostolgandins-> prevent inflamm in trigeminal |
|
|
Term
| 4 classes of analgeiscs to use |
|
Definition
aspirin
ibuprofen
naproxen
APAP + caffeine + aspirin |
|
|
Term
|
Definition
|
|
Term
| what is the clas sof drugs to prevent nausea/vomit |
|
Definition
|
|
Term
| what are the 2 dopamine antagonists |
|
Definition
metocolopromide
prochlorperazine |
|
|
Term
metoclopromide with aspirin is-
with APAP |
|
Definition
|
|
Term
| when should the antiemeitcs be given? |
|
Definition
| 30 min before the anti migraine meds |
|
|
Term
opioids are only used for what severity
frequency?
when is it indicated? |
|
Definition
moderate to severe
not frequent
when other are contrainidcated |
|
|
Term
| if pt doenst repsond to regular threapies, what cna be used as resuce ? |
|
Definition
|
|
Term
| frequent use of opioids leads to-2 |
|
Definition
depednece
rebound headaches |
|
|
Term
| what is the opiod for migraines? |
|
Definition
|
|
Term
| migraines exhibt effect thru how mnay 5ht recptors? |
|
Definition
|
|
Term
| what are the 2 mian serotonin recpotrs? |
|
Definition
|
|
Term
| thru the 5ht1b and 1d/ 2a recpotrs, seortinin can cause |
|
Definition
|
|
Term
| which serotonin recpot causes vasodilation? |
|
Definition
|
|
Term
| the best antimigraine meds are what serotinn agonists |
|
Definition
|
|
Term
| what are the first agents to use for acute migraines (mod-sever) |
|
Definition
|
|
Term
|
Definition
vasoconstrictors thru non selective 5 HT 1 and 2 agonists
also inhibts inflamm of trigmenial |
|
|
Term
| ergot alkaloids have a high affinty for what other 2 recptors |
|
Definition
|
|
Term
|
Definition
| htn, ischemia, hallucinatins, nausea |
|
|
Term
| ergotamine 2 clincial perals |
|
Definition
dont give IV
available with caffeine |
|
|
Term
|
Definition
|
|
Term
| contraindiactions for DHE and ergotamine-3 |
|
Definition
preggo!!!!!
hypoperfusion
coronary heart disease |
|
|
Term
| *caution use of DHE and ergotamine when using other migraine meds as with triptans=vasospasm, and reeduces beta blocker effect |
|
Definition
|
|
Term
|
Definition
|
|
Term
| triptans act on what recptors?-2 |
|
Definition
|
|
Term
| triptans do what thru 5HT 1b |
|
Definition
| vasoconstrict (cerebral and peripheral) |
|
|
Term
| triptans do what thru 5HT 1d |
|
Definition
|
|
Term
| which med is really effective during a migraine attack? |
|
Definition
|
|
Term
| what are contraindications for Triptans-2 |
|
Definition
Coronary heart disease
Raynaud's disease |
|
|
Term
whcih trigeminal serotonin recpotr is on postsnyaptic?
whic is presynaptic |
|
Definition
|
|
Term
| * each triptan has a max dose and frequency |
|
Definition
|
|
Term
|
Definition
|
|
Term
| which tritpan is injectiabe, tablet, and nsal spray? |
|
Definition
|
|
Term
|
Definition
sumatriptan
zolmitritptan
eletriptan |
|
|
Term
| whic triptans ahve better oral bioavailability?-2 |
|
Definition
|
|
Term
*triptan response cCANNOT be predicted
(if one fails, can use another) |
|
Definition
|
|
Term
triptans shouldnt be admin with _ for two weeks?
with _ for 24 hrs |
|
Definition
|
|
Term
| what is the interaction to be careful of when using triptans? |
|
Definition
|
|
Term
| *triptans are well tolerated just minor side effects |
|
Definition
|
|
Term
|
Definition
|
|
Term
| prophylaxis of migraines is higher/lower doses? |
|
Definition
|
|
Term
| MOA of beta blockers for prophylaxis? |
|
Definition
| modulate NA and 5HT transmission |
|
|
Term
| beta blockers for migraine prophylaxis-5 |
|
Definition
timolol
atenolol
propanolol
metoprolol
nadalol |
|
|
Term
| beta blockers are really useful if pt also has-3 |
|
Definition
anxiety
hypertension
angina |
|
|
Term
| *NSAIDS are only modest effective prophylaxis |
|
Definition
|
|
Term
|
Definition
| suppress prsotglandins/leukotrienes |
|
|
Term
| NSAIDS for migraine prophylaxis-3 |
|
Definition
aspirin
ketoprofen
naproxen |
|
|
Term
|
Definition
increase GABA
modulate glu
inhibit Na and Ca |
|
|
Term
anti epileptics for migraine prophylaxis-2
which block Na? which blocks AMPA/kainate? |
|
Definition
valproate (divalproex)
topiramate (topamax)
valproate, topiramate |
|
|
Term
| which anti epeliptic has hepatotxicity |
|
Definition
|
|
Term
TCAs for migraine prophylaxis MOA
which antidepressents didnt show effectiveness? |
|
Definition
down regulate 5HT and adrenergic recptors
SSRI, MAOI |
|
|
Term
| which is the msot popoular TCA for migraine prophylaxis |
|
Definition
|
|
Term
verapamil is useful for?
why? |
|
Definition
migraine porphylaxis
CA channel blocker |
|
|
Term
| what is the 5HT 2 antagonist for migraine prophylaxis |
|
Definition
|
|
Term
| 4 misc agents for migraine prophylaxis |
|
Definition
lisnopril
candasartan
riboflavin (B2)
boutlinum toxin A |
|
|
