Card Set Information
drugs headache 173 pharmacotherapy
what kind of stimuli triggers headache?
stress, fatigue, acute illness, sensitivity to alcohol
what are the 3 main types of headaches?
migraine (I,II,III), cluster, tension type
where is the pain location for a migraine?
sometimes bilateral (40%)
what is the pain quality of migraine?
associated symptoms of migraine
nausea, vomiting, photophobia, phonophobia
Usual time of onset for migraine
which gender is migraines most often?
What is the pain location of cluster headache?
unilateral, behind the right or left eye,
what is the pain quality of the cluster headache?
throbbing, sometimes piercing
what is the pain severity of cluster headache?
what is the duration of a cluster headache?
15min to 2 hrs
what are the associated symptoms of cluster headaches?
conjunctival redness, lacrimation, nasal congestion, rhinorrhea, ptosis, mitosis - all on the same side as the headache
what is the time of onset for cluster headache?
which gender is most common for cluster headache?
what is the pain location of tension type headache?
bilateral in "headband" configuration
what is the pain quality of tension type headache?
what is the pain severity of tension type headache?
mild to moderate
what is the duration of tension type headache?
30 min to 7 days
what is the usual time of onset of tension type headache?
what are the triggers of tension type headache?
what is the gender prevalence is tension type headaches?
slightly more common in females
identifiable underlying causes of headaches
severe hypertension, typerthyroidism, tumors, infection , disorders of the eye, nose, sinuses, and throat
two forms of the migraine I headache
migraine with aura and migraine without aura
what is the pathophysiology of the migraine I headache
trigger--> blood vessels contract around eye--> dilation pushes surrounding tissue and compress nerves--> nerves fire off because they think they are being damaged--> headache
what treatments abort an ongoing migraine I attack?
nonspecific analgesics and migraine specific drugs
what are the types of nonspecific analgesics?
aspirin like drugs and opioid analgesics
what are the types of migraine specific drugs
ergot alkaloids, serotonin 1B/1D receptor agonists (triptans)
what treatment is used to prevent attacks of migraine I headaches from occurring?
beta blockers, tricyclic antidepressants, anti epileptic drugs
what are the non drug measures used to treat migraine headache I
what is the objective of abortive therapy for migraine II headache?
to eliminate heacache pain and suppress associated nausea/vomiting
why is oral route of administration for Migraine II headache not effective and what is the best route of administration?
because of GI distress
best route of administration is through injection, inhalation, rectal suppository
what do all the selective serotonin 1B/1D receptor agonists end in?
what do triptans do?
triptans cause the blood vessels to shrink down
when would you use antiemetics for treatment of headache?
only if GI complications
what is the therapeutic use of ergot alkaloids?
drug of choice to stop an ongoing migraine
what are the adverse effects of ergot alkaloids?
weakness in legs, myalgia, numbs and tingling in fingeres or toes, angina like pain, tachycardia or bradycardia
what happens when you overdose with ergotamine?
what are the adverse drug interactions with ergot alkaloids?
triptans, CYP 3A4 inhibitors
what are the contraindications of ergot alkaloids?
hepatic or renal impairment
what are the therapeutic uses of dihydroergotamine?
drug of choice for terminating migraine and cluster headaches
what are the routes of administration for dihydroergotamine?
parenteral or nasal spray administration
what are the dihydroergotamine drug interactions?
CYP3A4 inhibitors, serotonin agonist
what are the contraindications for dihydroergotamine?
patients with CAD (coronary artery disease), PVD (peripheral vascular disease), sepsis, pregnancy, hepatic or renal impairment
what is the mechanism of sumatriptan (serotonin 1B/1F receptor agonists?
binds to receptors on intracranial blood vessels and causes vasoconstriction
diminishes perivascular inflamation
that is the therapeutic use of sumatriptan?
aborting the ongoing migraine attack to relieve headache and associated symptoms
what the the routes of administration for sumatriptan?
oral or intranasal administration (very fast acting inject it in the leg)
what are the adverse effects of sumatriptan?
chest symptoms, coronary vasospasm, teratogenesis, vertigo, bad taste when taken intranasal form
what are the drug interactions of sumatriptan (serotonin 1B/1D receptor agonists)
ergot alkaloids, sumatriptan, other triptans
what is the preferred drug for migraine prevention?
how often does cluster headaches happen?
1-2 attacks every day for 2-3 months
what is prophylaxis?
action taken to prevent disease
how do you treat cluster headaches?
primary therapy directed at prophylaxis
what is the treatment of tension type headache?
patient teaching on how to manage stress