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18 Cards in this Set
- Front
- Back
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What are the 3 major types of headache?
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Tension
Migraine Cluster |
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How is a migraine differentiated from other headaches?
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-It may have an aura
-It is debilitating --Associated with photophobia, phonophobia, nausea, vomiting |
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Cluster headaches involve what cranial nerve and brain center?
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Hypothalamus (remember clusters are rhythmic...)
Trigeminal Nerve |
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Describe the neurovascular theory of migraine?
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-Abnormal excitation of Nuc. Caud. and Brainstem
-Trigeminal nerve irritation -Vasodilation and release of CGRP, Substance P, 5HT, NKa |
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What receptors are implicated in the cause of migraine
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5HTb and 5HTd. In migraine they are upregulated
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What is used for acute treatment of cute cluster headache?
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O2, parentral sumatriptan, zolmitriptan nasal spray, DHE
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What is used in the treatment of tension headache?
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NSAIDS, tricyclics (chronic cases)
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What is used to treat acute migraines?
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General pain: NSAIDS, opiates, steroids
Migraine: triptans, ergot alkaloids, DHE |
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What is primarily used for long term cluster headache treatment?
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Verapamil
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What class of drugs are 5HT b/d agonists? What is the prototype drug?
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Triptans
Sumatriptan is the prototype |
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How do triptans work?
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-Blood vessel constriction
-Reduction of neuropeptide release -Reduction of NT release |
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What are the advantages of the second generation tryptans?
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-Available in nasal/dissolved form
-More bioavailable -More Lipophillic |
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What are the contraindications of triptans?
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Ischemic Heart disease
Uncontrolled hypertension Renal disease Basilar Migraine Familial hemiplegic migraine |
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What drugs interactions are important to note when using triptans
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SSRI's MAOI's. They can cause serotonin sydrome.
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What is the site of action of the ergot alkaloids?
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They are general 5HT1 agonists.
This makes them less specific and have more side effects then triptans |
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What are the side effects of ergot alkaloids?
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Vasoconstriction, hyoertension and associated bradycardia, addiction
With SSRI's MAOI's, or Triptans they may cause serotonin syndrome |
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What are contraindications for ergot alkaloids
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Ischemic heart disease
Uncontrolled hypertension Basilar migraine Familial hemiplegic migraine Pregnancy |
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What can be used for prophylactic migraine treatment?
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propanolol (beta blocker, 5HT2 antagonist), topiramate (GABA and AMPA), amytryptaline (tricyclic), divalproex sodium (anticonvulsant)
Start on low doses, wait 3 monts to see effects |
