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46 Cards in this Set
- Front
- Back
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Antimigraine drugs relieve the pain of _____ _____ by ________ dilated ________ arteries.
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Vascular headaches
Narrowing Cerebral |
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The two classes of anti-migraine?
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5-HT Agonists and Ergotamine derivatives
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Pt's with:
1. Ischemic heart disease or other cardiovascular disorders and 2. Uncontrolled hypertension should not use_________ because___________. |
5-HT Agonists...because they tend to cause coronary vasospasms.
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How do antimigraine meds interact with vasoconstrictors?
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Vasoconstriction increases.
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Can you use 5-HT Agonists with Ergotamine-containing preparations?
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Yes...but 5-HT's may not be used w/in 24 hours of taking the Ergotamine.
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Can 5-HT Agonists be used with MAO I's?
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No.
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What's the relationship between Ergotamines and pregnancy?
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Ergot alkaloids are oxytocic. They induce uterine contractions (labor).
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How are Ergotamines absorbed by the body (GI tract)? Quickly, Slowly...incompletely?
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- Slowly and incompletely.
Traces of ergot remain in various tissues which accounts for it's long-lasting and toxic actions. |
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Antimigraine meds have an increased ability to relieve pain and reduce symptoms when they are _______?
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Used at the ONSET of the attack.
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How is a vascular headache (migraine) diagnosed?
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If the pt's pain is relieved after an IM injection of 1 ML of ergotamine?
Vascular headache...confirmed. |
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Antimigraine meds are available in what forms?
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- PO
- Sublingual - Parenteral - Rectal |
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What determines the best route for antimigraine meds?
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The goal.
'are you trying to prevent or treat the migraine'? |
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Sublingual antimigraine tablets are absorbed slowly and incompletely from the GI tract? T or F
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FALSE.
Sublingual = faster absorption Sublingual > rectal or oral preparations |
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Oral, rectal, IM and SubQ antimigraine meds are absorbed __________ and ___________ from the GI tract.
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Slowly and incompletely.
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How does caffeine affect oral and rectal ergotamine preparations?
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Caffeine speeds up absorption.
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When would the rectal form be used for antimigraine?
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Pt's vomiting & oral preparations cannot be tolerated.
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S/S of Anti-migraine Overdosage?
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P ain, muscle (even at rest)
E xtremities (numb, pale, cold) P ulses, arterial (decreased/absent). C onfusion/convulsions i D epression/drowsy M iosis, (fixed pupils) P aralysis (hemiplagia) |
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S/S of antimigraine Adverse Reactions?
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N ausea/vomitting
o W eakness (legs) & T achycardia H eart Murmer E dema N eutropenia (of the blood) ...with localized pruritus. |
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When assessing a pt, how would you determine if adverse reactions, OD'sage or toxicity is developing?
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1. Monitor b/p standing, sitting and lying.
2. Check peripheral pulses. |
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Pt's using anti-migraine agents long-term are R/F?
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O D'sage (acute)
or C hronic toxicity |
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Pt's who abruptly stop anti-migraine agents are R/F?
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Rebound migraine.
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PT Teaching:
Pts should ensure that their arms and legs do not _______ after taking anti-migraine meds. |
Get cold.
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PT Teaching
For a pt on anti-migraine meds, when should the hlth care provider be notified? |
If limbs become:
- cold - numb - painful upon walking |
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PT Teaching
Oral anti-migraine meds may be taken with milk or meals? T or F |
TRUE.
Oral anti-migraine meds produce stomach upset. Can be taken with milk or food to decrease the effect. |
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Common side effects of anti-migraine meds?
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- Headache
- Nausea & vomiting - Diarrhea & Dizziness - Lightheadedness when rapidly changing positions |
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PT TEACHING
How would the pt relieve side effects of anti-migraine meds? |
- Take drug
- Lie down immediately - Quiet, dark room with soft music |
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PT TEACHING
Contact hlthcare provider if ___ mg or more of oral ergotamine is needed to relieve migraine pain |
8 MG
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PT TEACHING
Antimigraine medication is safe for use by a female pt who suspects she is pregnant? T or F. |
FALSE
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Ergot alkaloids are anticholinergic? T or F
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FALSE.
They are adrenergic blocking agents |
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How do adrenergic blocking agents (ergotamines) work?
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- Dilate smooth muscle tissue...which reduces cerebral blood flow and arterial pulsing...which reduces headache.
- Decrease b/p - Increase uterine contractions |
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How do 5-HT agonists treat migraine headaches?
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They constrict cranial vessels and block neuropeptides that cause inflammation
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ASSESSMENT
What health-related factors might affect the pt's use of anti-migraine drugs? |
- Coronary Artery Disease
- High Blood Pressure |
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HERBAL SUPPLEMENTS
What types of herbal remedies are utilized for migraine headaches? |
- Feverfew
- Gingko - White Willow |
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How do 5-HT agonists combat migraines?
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They constrict cranial vessels and block neuropeptides that cause inflammation
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ASSESSMENT
What health factors might affect a pt's use of anti-migraine drugs? |
- Coronary Artery Disease
- High Blood Pressure |
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MIGRAINE ASSESSMENT
Pt c/o one-sided pain felt over one eye. Is photophobic & sensitive to sound as well as being privy to nausea and vomiting. |
.......
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MIGRAINE ASSESSMENT
Pt with family h/o headaches and childhood motion sickness. Clustered headaches that may be relieved by sleeping, vomiting or drinking caffeinated drinks. |
..........
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HERBAL SUPPLEMENTS
What alternative therapy is utilized for migraine headaches? |
- Feverfew
- Gingko - White Willow |
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HERBAL SUPPLEMENTS
What drugs interact adversely with feverfew, ginkgo and white willow? |
- NSAIDS
- Anticoagulants - Aspirin - Antiplatelet |
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HERBAL SUPPLEMENTS
Gingko may interact adversely with which 2 additional drugs? |
- MAO Inhibitors
- Acetlycholinersterase inhibitors |
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HERBAL SUPPLEMENTS
White Willow may interact adversely with which additional drugs? |
- S pironolactone
- P henytoin/Probenecid a - M ethotrexate/Metoclopramide ...and valproic acid |
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HERBAL SUPPLEMENTS
S/S of drug reactions |
- Limbs, (sweaty hands/feet)
- Scalp tenderness - Pupil (miotic) - Eye, red - Nose (Unilateral congestion) |
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DRUGS
What are some medications for the Ergotamine Derivatives class? |
1. DihydroergotAMINE
DHE 45 Migranal 2. ErgotAMINE Ergomar |
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DRUGS
What are some medications for 5-HT? |
Generic Trade
AmoTRIPTAN Axert NaraTRIPTAN Amerge RizaTRIPTAN Maxalt SumaTRIPTAN Imtrex ZolmiTRIPTAN Zomig |
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DRUGS
What medication ends in '-tamine'? |
Ergotamine Derivatives
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DRUGS
What medications end with the suffix '- triptan'? |
5-HT Agonists
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