Pharm Ii Exam 1 - Drugs For Headaches

Front 1

1. First phase of a migraine attack

Back 1

a. Characterized by vasoconstriction and ischemia
b. The release of serotonin from CNS neurons and circulating platelets contributes to first phase
-----Hence antiplatelet drugs and serotonin antagonist are used for migraine prophylaxis

Front 2

1. Second phase of a migraine attack

Back 2

a. Longer than 1st phase
b. Characterized by vasodilation and pain
c. Trigeminal nervous system appears to play a role in phase 2
-----By releasing substance P and calcitonin gene-related peptide (CGRP)
-----Which triggers vasodilation and inflammation

Front 3

1. Prophylactic migraine therapy focuses on:

Back 3

a. preventing vasoconstrictive phase
b. Considered effacious if it decreases the amount of migraines by half

Front 4

1. Abortive therapy for migraines Focus on:

Back 4

a. reversing the vasodilation phase

Front 5

1. 5HT2 receptors are located on

Back 5

a. smooth muscle and platelets
-----Where they mediate vasoconstriction and platelet aggregation
-----This is why methysergide is effective

Front 6

1. Ergot alkaloids originate from:

Back 6

a. Claviceps purpurea, a fungus infecting mostly rye grain

Front 7

1. three classes of of ergot alkaloids:

Back 7

a. amine ergots,
b. amino acid ergots,
c. atypical

Front 8

1. Amines ergots include these drugs:

Back 8

a. LSD,
b. ergonovine,
c. methylergonovine,
d. methylsergide

Front 9

1. amino acid ergots include these drugs:

Back 9

a. ergotamine,
b. dihydroergotamine,
c. bromocriptine,
d. ergoloids

Front 10

1. atypical ergots include these drugs:

Back 10

a. pergolide,
b. cabergoline

Front 11

1. Most potent hallucinogenic ergot

Back 11

a. LSD

Front 12

1. MOA of LSD

Back 12

a. partial agonist at 5-HT1A autoreceptors on raphe cell neurons decreases
neuronal activity and agonism at postsynaptic 5-HT1A and/or 5-HT2A/C receptors in visual processing centers

Front 13

1. ergots for acute migraine attack:

Back 13

a. ergotamine,
b. dihydroergotamine
c. ergot and caffeine,
d. or other ergot combos

Front 14

1. ergots for migraine prophylaxis:

Back 14

a. methylsergide,
b. ergot combinations

Front 15

1. Adverse effect common to all ergots at normal doses

Back 15

a. diarrhea and N/V

Front 16

1. Adverse effect common to all ergots at High doses

Back 16

a. CNS stimulation and hallucinations

Front 17

1. Characteristics of a cluster headache

Back 17

a. Severe,
b. unilateral,
c. retro-orbital;
d. clustered over time

Front 18

1. Drugs for preventing Cluster headaches

Back 18

a. Lithium,
b. methysergide, and
c. verapamil

Front 19

1. Drugs for aborting cluster headaches

Back 19

a. DHE,
b. ergotamine,
c. glucocorticoids,
d. lidocaine,
e. oxygen, and
f. sumatriptan

Front 20

1. Characteristics of a migraine headache

Back 20

a. Moderate or severe,
b. often unilateral,
c. usually pulsatile;
d. occur with or without aura

Front 21

1. class of drugs for preventing migraine headaches

Back 21

a.anticonvulsants,& antidepressants
b. BB, ,
c. CCB
d.NSAIDs,
e.serotonin 5-HT2 receptor antagonists

Front 22

1. Drugs for aborting migraine headaches

Back 22

a. DHE,
b. ergotamine,
c. isometheptene,
d. NSAIDs,
e. tramadol,
f. and triptans*

Front 23

1. Characteristics of tension headaches

Back 23

a. Mild or moderate,
b. bilateral,
c. nonpulsatile;
d. exert band-like pressur

Front 24

1. Drugs for preventing tension headaches

Back 24

a. Amitriptyline

Front 25

1. Drugs for aborting tension headaches

Back 25

a. Muscle relaxants and NSAIDs

Front 26

1. MOA of Dicalproex sodium

Back 26

a. Anticonvulsants and Antidipressants used to tx headaches

Front 27

1. MOA of Amitriptyline

Back 27

a. TCA
b. Anticonvulsants and Antidipressants used to tx headaches
c. FUNCTIONS BY INHIBITING SERATONIN REUPTAKE

Front 28

1. Clinical use of Amitriptyline

Back 28

a. Preventing migraine headaches
b. Preventing tension headaches

Front 29

1. MOA of Fluoxetine

Back 29

a. SSRI
b. Anticonvulsants and Antidipressants used to tx headaches

Front 30

1. MOA of Phenelzine

Back 30

a. MAOI
b. Anticonvulsants and Antidipressants used to tx headaches
c. BLOCKS degredation of 5HT

Front 31

1. Anticonvulsants and Antidipressants used to prevent migraine headaches

Back 31

a. Dicalproex sodium
b. Amitriptyline
c. Fluoxetine
d. Phenelzine

Front 32

1. CCB used to prevent migraine headaches

Back 32

a. Verapamil
b. Nimodipine

Front 33

1. MOA of Verapamil

Back 33

a. Non- Dihydropyridine CCB
b. Other Non- Dihydropyridine CCB include
-----Diltizem

Front 34

• Adverse effects of non- Dihydropyridine CCB

Back 34

o AV block
o Bradycardia
o Constipation
o Dizziness
o Edema
o Gingival hyperplasia
o Headache
o Heart failure

Front 35

• Drug interactions of Non- Dihydropyridine CCB

Back 35

o Increases serum levels of
-----Carbamazepine
-----Digoxin
-----Theophylline
o Decreases serum levels of
-----Lithium

Front 36

• Clinical use of Non- Dihydropyridine CCB like verapamil in tx headaches

Back 36

o migraine prophylaxis
o Cluster headache prophylaxis

Front 37

• MOA of Nimodipine

Back 37

o Dihydropyridine CCB
o Other Dihydropyridine CCB include
-----Felodipine
-----Amilodipine
-----Nicardipine
-----Nifedipine

Front 38

• Adverse effects of Dihydropyridine CCB

Back 38

o Dizziness
o Edema
o Gingival hyperplasia
o Headache
o Tachacardia (reflex tachacardia)

Front 39

• drug interactions of Dihydropyridine CCB

Back 39

o Serum levels of Dihydropyridine CCB is increased by:
-----Azole antifungal cream
-----Grapefruit juice

Front 40

• NSAID’s used to prevent migraine headaches

Back 40

o Naproxen
o Fenoprofen

Front 41

• Clinical use for Naproxen

Back 41

o Can be used for the prevention and treatment of migraine
o Reduces release of 5HT

Front 42

• Clinical use for Fenoprofen

Back 42

o Can be used for the prevention and treatment of migraine
o Reduces release of 5HT

Front 43

• BB used to prevent migraine headaches

Back 43

o Propranolol
o Timolol
-----BB w/o ISA activity are suitable

Front 44

• MOA of Methysergide

Back 44

o 5HT-2 receptor blocker
o It is an Amine ergot

Front 45

• Adverse effects of Methysergide

Back 45

o Common to all ergots at low doses
-----Diarrhea
-----N/V
o Common to all ergots at High doses
-----CNS stimulation
-----Hallucinations
o Specific for methylsergide
-----Chronic use --> fibroplastic changes in the pleural cavity ans endocardial tissue

Front 46

• Contraindications (I think this is for ergots) Methysergide

Back 46

o Obstructive vascular and/or collagen disease
o HTN
o Pregnancy
o Psychosis

Front 47

• Clinical use of Methysergide
**how long does it take to see effects?

Back 47

o migraine prophylaxis
-----effects take 1-2 days to develop and 1-2 days to disappear once the drug is stopped
o Cluster headache prophylaxis

Front 48

• Clinical use for Gabapentin

Back 48

o Seizure disorder
o Postherpedic neuralgia
o Prophylaxis for migraines

Front 49

• Clinical use for Feverfew/ginger

Back 49

o Herbal remedy with moderate effect of preventing migraines

Front 50

• Clinical use of Vitamin B2 (riboflavin)

Back 50

o Reduces frequency and duration of migraine attacks
o Used prophylactocally

Front 51

• MOA of Dihydroergotamine

Back 51

o 5-HT1D/1B Receptor agonist
o Amino Acid ergot

Front 52

•_____&______________are the only ergots with the potential for dependance

Back 52

o Ergotamine & Dihydroergotamine
o Pts who take erotamine for an extended periopd of time may become dependent on it and require progressively increasing doses for relief of vascular headaches, and for prevention of dysphoric effects which follow withdrawl of the drug

Front 53

• Adverse effects of Dihydroergotamine

Back 53

o Common to all ergots at low doses
-----Diarrhea
-----N/V
o Common to all ergots at High doses
-----CNS stimulation
-----Hallucinations

Front 54

• Contraindications (I think this is for ergots) Dihydroergotamine

Back 54

o Obstructive vascular and/or collagen disease
o HTN
o Pregnancy
o Psychosis

Front 55

• Clinical use of Dihydroergotamine

Back 55

o Aborting migraine headaches
o Aborting cluster headaches

Front 56

• MOA of Ergotamine

Back 56

o 5-HT1D/1B Receptor agonist
o Amino Acid ergot

Front 57

• Adverse effects of Ergotamine

Back 57

o Common to all ergots at low doses
-----Diarrhea
-----N/V
o Common to all ergots at High doses
-----CNS stimulation
-----Hallucinations
o Specific for Ergotamine and Ergovine
-----Prolonged vasospasm can lead to gangrene of extremities and bowel infarction

Front 58

• Contraindications (I think this is for ergots) Ergotamine

Back 58

o Obstructive vascular and/or collagen disease
o HTN
o Pregnancy
o Psychosis

Front 59

• Clinical use of Ergotamine

Back 59

o Aborting migraine headaches
o Aborting cluster headaches

Front 60

• MOA of Sumatriptan

Back 60

o 5-HT1D/1B Receptor agonist

Front 61

• Clinical use of Sumatriptan

Back 61

o Aborting migraine headaches
o Aborting cluster headaches

Front 62

• MOA of Zolmitriptan

Back 62

o 5-HT1D/1B Receptor agonist

Front 63

• Clinical use of Zolmitriptan

Back 63

o Aborting migraine headaches
o Aborting cluster headaches

Front 64

• MOA of Rizatriptan

Back 64

o 5-HT1D/1B Receptor agonist

Front 65

• Clinical use of Rizatriptan

Back 65

o Aborting migraine headaches
o Aborting cluster headaches

Front 66

• MOA of Naratriptan

Back 66

o 5-HT1D/1B Receptor agonist

Front 67

• Clinical use of Naratriptan

Back 67

o Aborting migraine headaches
o Aborting cluster headaches

Front 68

• Other drugs for aborting migraines

Back 68

o Isometheptene
o Tramadol
o Butophanol
o Acetaminophen / codine
o Acetaminophen/caffine/butalbital
o Naproxen
o Prochloperazine

Front 69

• Clinical use of Lithium

Back 69

o Abort Cluster headache

Front 70

• Clinical use of glucocorticoids

Back 70

o Aborting cluster headaches

Front 71

• Clinical use of Lidocaine

Back 71

o Aborting cluster headaches

Front 72

• Clinical use for Oxygen

Back 72

o Aborting cluster headaches