問題一覧
1
Define Migraine Headache (3 marks)
-Severe, throbbing, vascular headache -repeated unilateral head pain -comes with neurologic and GI disturbances
2
What are the classic migraine components in order (7 marks) & are all of them experienced by everyone? If so, which is/isn’t?
-prodrome, aura, headache, headache relief, postdrome. -no, aura.
3
What is Prodrome?
The first phase of migraine. Symptoms include: mood swings, anger, confusion, tremor, depression, anxiety, irritability. Known as preheadache
4
What is Aura?
Sensory sensitive to light/sound & feeling of deja vu (sensory disturbance)
5
What is Postdrome?
The last stage of migraine, happens after the headache. Results of symptoms in fatigue, mental fog and body ache
6
What are the symptoms of migraine?
Severe throbbing pain , Nausea , Photophobia, Phonophobia , Physical activity, Acute migraine attacks
7
Which of the following causes migraine?
Serotonin decreases , Vasodilation in Cranial arteries, Unstimulated serotonin receptors
8
How to reduce or prevent migraines?
By stimulating serotonin receptors to block the production of CGRP, Having enough lvl of serotonin to stimulate the receptors, Causing vasoconstriction, Serotonin inducer
9
Which are migraine triggers?
Diet, Stress, Depression , Sleep habits, Certain medications, Oral contraceptives , Hormonal fluctuations , Atmosphere changes, Environmental irritants
10
What the initial treatment of migraine? (3 marks)
-identify + remove triggers -lying down in quiet + dark room -sleeping may help
11
For severe/frequent attacks, which drug therapy may be indicated?
Sedative, Antiemetic, Narcotic agents
12
What are the 2 classes of migraine drug therapy?
Prophylactic therapy + abortive therapy
13
What does Prohylactic therapy do?
Attempts to prevent/reduce recurrence of migraine
14
What does Abortive therapy do?
to be taken after acute migraine occurs, to be taken @ first sign of migraine (aura/headache)
15
Which are prophylactic therapy?
Anticonvulsants , Beta blockers , Calcium channel blockers , Estrogen , Feverfew (a natural herb) , NSAIDs , SSRIs , Tricyclic antidepressants
16
Which are abortive therapy?
Serotonin-containing medications , Ergotamine-containing medications , Narcotic analgesics , Non-narcotic analgesics (i.e. NSAIDs)
17
Which are ergot derivatives
dihydroergotamine (Migranal) , ergotamine (Ergomar) , ergotamine-caffeine (Cafergot*)
18
Which are triptans?
almotriptan (Axert) , eletriptan (Replax*) , frovatriptan (Frova) , naratriptan (Naramig*) , rizatriptan (Maxalt*) , sumatriptan (Imigran*) , zolmitriptan (Zomig*)
19
What are the adverse effects of Triptans? Choose the common:
Pain, tightness, burning at site of inj , Dizziness, Fatigue, Nausea, Hot flashes, Dry mouth
20
What are the adverse effects of Triptans? Choose the less common + serious:
Stroke, High BP, Myocardial infarction (heart attack), Coronary vasospasm , Angina, Arrhythmia
21
Which are opioid analgesic?
Butorphanol (Stadol, Stadol NS)
22
Which are beta blocker?
propranolol (Inderal)
23
Which are Tricyclic Antidepressant?
Amitriptyline (Generics)
24
Which are Anti-convulsant?
Valproate
25
Which are Antiemetic?
chlorpromazine (Thorazine) , metoclopramide (Reglan, Premosan*) , prochlorperazine (Compazine)