Term
| Which HAs require further investigation? |
|
Definition
- new onset HA in middle to late life - HAs that disturb sleep - HAs assc. with neurologic symptoms - signs of meningeal irritation - HAs assc. with impaired consciousness |
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Term
|
Definition
mild OTC analgesics, like ASA, tyl., NSAIDS sk mm relaxants if needed if HA occur daily/chronically TCAs (esp in pts who are also depressed) |
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|
Term
|
Definition
mild OTC analgesics if sxs persist use antibiotics +/- nasal decongestants |
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Term
|
Definition
stop drinking and smoking corticosteroids 100% O2 ergots SL or supp. triptans CCB, lithium, Valproate -- long term abortive -- SQ sumatriptan |
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Term
|
Definition
| serotonin agonist, produces vasoconstriction |
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Term
| Problems with ergot alkaloid use in HAs |
|
Definition
chronic use can lead to status migrainus degradation can lead to vasodilation and HAs |
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|
Term
|
Definition
SEs: NVD, cold skin CIs: CAD, PVD, Pregnancy |
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Term
| What are the triptan drugs? |
|
Definition
sumatriptan zolmiptriptan naratriptan flovatripatan rizatriptan electriptan almotriptan |
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|
Term
|
Definition
| selective serotonin agonist, vasoconstrictor |
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|
Term
| What is improved with new triptans? |
|
Definition
they are more lipid soluble and they achieve quicker and higher CNS concentrations |
|
|
Term
| what are the SEs and CIs of triptans? |
|
Definition
SEs: cold extremities, tight chest, dizziness, coronary vasospasm CIs: angina, MI, CAD Can get into a rebound HA, med cycle |
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|
Term
| Dose Example for sumatriptan |
|
Definition
25-100 max 200 response rate 50-69 |
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|
Term
| Migraine Treatment - abortive |
|
Definition
OTC analgesics NSAIDS + codeine Tramadol Ergot alkaloids triptans |
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|
Term
| Migraine Treatment - prophylaxis |
|
Definition
Anticonvulsants: valproate, carbamazepine Antidepressants: SSRIs, TCAs
NSAIDS: Ibuprofen, naproxen
Beta Adrenergic Receptor Antagonists: propranolol, timolol, nadolol CCB: Verapamil Serotonin Receptor Antagonists: Methysergide |
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Term
|
Definition
| prevents vasoconstriction phase |
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|
Term
|
Definition
| probably prevent the vasconstriction phase |
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|
Term
| Beta-Adrenergic Receptor antagonist MOA |
|
Definition
| may decrease SE release from platelets |
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|
Term
|
Definition
| block thromboxane synthesis and platelet aggregation to reduce release of SE |
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|
Term
anticonvulsant SEs (valproate, carbamazepine) |
|
Definition
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|
Term
|
Definition
1. Avoid precipitating factors 2. abortive 3. prophylaxis |
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