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13 Cards in this Set

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International Headache Society Classification: Primary Headache
-Tension headache
-Cluster headaches
-Migraine headaches
International Headache Society Classification: Secondary Headache
-Organic disorders:
-Hemorrhage
-Infection
-Stroke
-Tumor
Primary Headache: Tension headache
-bilateral
-band-like pressure
-dental, cervical, visual corrections
Primary Headace: Cluster headaches
-unilateral
-behind eye
-15 min to 3 hrs
-0.5% of population
Migraine: Elements (?)
-Triggers (stress, anxiety, hormones, chocolate)
-Disorder of cranial blood vessels
-Involvement of 5HT and/or NE
-May involve glutamate, NO, histamine sensitivities
-Trigeminal nerve (V) sensory afferents
Migraine: Phases
-Premonitory
-Aura
-Headache
-Postdrome
Migraine: Premonitory phase
-60%
-hrs/days
-psychological, sensory or autonomic
Migraine: Aura phase
-20%
-visual, sensory, motor, language disturbances
Migraine: Headache phase
-4 to 72 hrs
-photophobia, phonophobia, sensory stimulation
Migraine: Postdrome phase
-up to 24 hrs
-euphoric, depressed, irritability
Migraine: Neurogenic model
-neuronal dysfunction w/subsequent vascular changes
-release of vasoactive neuropeptides:
-Sub P
-Calcitonin gene related peptide
-Neurokinin A causing vasodilation
-Plasma extravasation
-Mast cell degranulation
-Neurogenic inflammation
-Ascending projections of trigeminal nerve activate thalamic pain centers
-Facial nerve (VII) activated
Migraine: Acute treatment (Mild to Moderate)
-Oral analgesics (Aspirin, NSAIDS, Acetaminophen)
-Ketorolac:
-stronger NSAID
-IM or oral
-decrease pain, nausea, photophobia
-Antiemetic agents
-chloropromazine
-metoclopromide
-promethazine
Migraine: Actue treatment (Moderate to Severe)
-Ergots
-vasoconstrictors
-Ergotamine tartrate (oral or suppository)
-Dihydroergotamine (IM or nasal spray)
-Triptans
-Opiates
-MOA:
-activate 5HT 1D/1B
-activate presynaptic 5HT 1D/1B receptors