Term
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Definition
| migraine headaches, clusterh eadaches, tension type headaches |
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Term
| secodnary headache disroders |
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Definition
| headaches asociated with ehad trauma, vascualr disorders, CNS infecitons ,metabolic disroders , brain tumors |
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Term
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Definition
| morefrequent ocurence in women, bilateral.unilearterl, pulsating quality, aggravated by physical routine, nausea and vomitting, phosto,osmo,phonobia, alelviation bysleep, famimlydisposition. |
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Term
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Definition
| classic migraine, not as common as without aura. Aura can be visual, sensory, somatic . IT is abrupt onset neuroloic change that is fully reversible adn short acting. visual auras are the most common. |
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Term
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Definition
| aura symptosm are more pronounced, and disabling and logner lasting. |
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Term
| pathphys of migraine headaches |
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Definition
| bloodflow related- trigeminal nerve system in brainstem becomes overexcited. Trigeminal neurons release vasodilator neuropepdides. Vasodilation displaces pain sensitive intracarnial structures. Levels of serotinin (a casonconrtictive neruotransmitter) are diminished |
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Term
| some riskf actors for migraine |
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Definition
| stress, alelrgic reactions, pressure hcanges, altered sleep, alcohol use, bright lights, loud noises, odors or perfumes, excessive cafeine or withdrawal, sokingor expousre to smoke ,skipipng meals, hypoglycemia, hormonal fluctations oral conraceptives, foods. |
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Term
| migraine diagnosis and testing |
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Definition
| based on symtpmos and medical nad fmaily history. A lack of important physical findings is important fordiagnosis. If headaches not recent origin and not asosciated wit htrauma/ neuro deficits then dianogsit precdures are uneessary. THough they are sometimes they are obtaiend (mri/cat scan) to reulte out other causes ofh eadachesi n cases of complicated migraine |
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Term
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Definition
| avoidance of trigers: keeping ehadache diary. Abortive therpay: pharmacotheraphy aimed at releiveing haeadache pain and asosciated symptoms- inlcuindg anaglesics, serotoinin recpetor agonsits, anti-emetic therapy. |
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Term
| Serotinin descritpion adna classes |
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Definition
| synthesized from tyrptohphan. Serotnon receptor classes: 7 classes , G-rpotein coupld receptors and ligandated ion channel. |
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Term
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Definition
| cardiovascular: powerful diret vascoonstriction except inskeletal muscleand heart whereti dialtes blodo vessels. GI: contracts GI smooth msucle increasing tone nad stimulating peristalisis. 90 percento f seratonin in in enterchromaffin cells of GI tracts. |
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Term
| Triptans (descritpion, duration of action, receptors operating on, side effects, cost) |
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Definition
| sumatriptan, preferred intialt herapy for patients with moderate to severe migraines. improve symtpoms. effective four hours or logner aftero nset of heacheSelectively stimulate ***sertonergic5 h-t 1b/1d*** . Relatively few side effects (some incldue tingling, dizines and midle chest/throat tightness).more expensie than ergots |
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Term
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Definition
| reduce excitaiblity of trigeminal neruons and subsequent relase of vasodilatory neuropeptides. Vasoconstriction of cerebral and extracerebral vessels due to vascular serotonin receptors. |
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Term
| triptan contraindications |
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Definition
| Should not be used with patients with heart disease (conorary vascualture also contains serotonin receptors), prescribed dosage shoudl nto be excedded due to risk fo cardiac ischemia. Contraindicaitons- Uncontrolled hyeprtension, concomittant use of alkaloids, triptans, and otehr serotinin agonists - due to potential for preciptaitng serotinin syndrome. |
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Term
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Definition
| structural analgo of sertonin, first approvied tritpan. (avilable as oral tablets, subq, and snasal spray- useful for vomitign patients). fast acting, but short halflife (so headaches can recur within 24 horus of injection) |
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Term
| sceond generation triptans |
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Definition
| zolmitriptan naratriptan rizatriptan almotritpan frovatripatn eletritpan. Improved oral biovaility over suamt triptan. paritents may respond to some triptants better than others. |
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Term
| triptan with lognesth alf life |
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Definition
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Term
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Definition
| eletriptan, and almotriptan. |
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Term
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Definition
| derivatied of lyseric acid. Preferred agents of releif pre triptans. Must be taken at earliest sign of migrain attack to be efective. |
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Term
| ergot alkaloids side effects |
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Definition
| lostso f adverse effects that are serious becuase stimualtes a varitety of serotonergic and noradrennergic recpetors and dompaminergic receptors. (useshoudlbe limited to no more than twice a week). Adverse effects: anusea omiting , anroexia, adn cardiac ischemia. Also severe peripheral vasocontrie effects (gangrene in serious cases). Also reboudn headache after discontionation of logneterm use. |
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Term
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Definition
| (use ergotamien tartarate and dighydroergotamine). can be given orally. Proposed mOA: inhibits releaseof neuropeptides , vasocontration of brain lood vesels. Caffeine cobined with ergotamine to potentiate vasoconstrictive effects. |
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Term
| contraindications erogtamine |
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Definition
| coronaory arteyr disease, hypertension, peripher/cerebral vascular disease, anemia maulnutrition, liver and kidney disease, breast feedign , CANT BE USED WITH ergotamien metabolism inhibitors *erythromycin) or with triptans. |
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Term
| abrotive treatment of itnractblaem irane |
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Definition
| migraine that doenst respond to ordinary tehrapy usually requireing parenteral therapy. use DIhydroergotamine, and sumatriptan. |
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Term
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Definition
| may benefit some patients: paritcualry in those whose headaches impacthteir lives even with arotive therapy, or who have headaches so ffrequently taht abortive therapy is overusedw or if headaches are unresponsive to abortive treatment, or patients in whom abrotive treatmenti s contrindicated, or the presence of headaches leads to serious morbidiy or mortality risks |
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Term
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Definition
| first line prophylatic agent. b- adrenergic blocking agnet. |
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Term
| propanolol adverse effects |
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Definition
| mild (diziness drowsiness, unusual weakness, restlessnes, tremor, nadeaase, bradycardia, bronchospasm) |
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Term
| propanolol contraindications |
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Definition
| cardiogenic shock, valvular disease, bronchial asthma, bonchispasm. |
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Term
| Atmitryptiline :intro, MOA |
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Definition
| first line agent for prophylaxis, blocks reuptake of seratonin at central sites (originally tricylcic antidepressant). However, other selective serotonin reuptake inhbiitors to dnot appear to be effective. |
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Term
| amitryptilline adverse effects and contrindicaitons |
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Definition
| include: dry mouth ,blurred vision, weight gain, difficulty thinking. Contraindications: shitory of seizure disorders, pregnancy, children under 12 |
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Term
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Definition
| calcium channel blocker. Second line agents of proph. Efects are modesdt comapred to propanolol and amitryptiline. 308 weeks requiredfor ersponse. |
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Term
| verapamil adverse effecs and cotnraindications |
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Definition
adverse effecst: vertigo, hypotension,anusea, muscle fatigue cosnitipation.
contraindications: hypotension, cardiogenic shock ,CHF> |
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Term
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Definition
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Term
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Definition
| THird line prophylatic agent . Very effective but with severe side effects |
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Term
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Definition
| semi-syntehtic ergot alkaloid, |
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Term
| methysergide side effects and contraidnciations |
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Definition
| gi disturbacnes fibrotic changes andexcarcerbation fo cornoartyartery disease and angina. Contrindicaitons: coronoary arteyr diesase kp, peripheral or cerebral vascular disease, uncoroleld hypertension, hepatic disease, peptic ulcer disease, pulmonary disease, rhuematodi arhtiritsi, pregnancy ,breast feeding. |
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