Term
| Name the characteristics of a Migraine headace |
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Definition
Family history present Common in females Onset is variable Pulsating and throbbing duration is 2-72 hrs Might see aruas and sensitive to light & sound |
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Term
| Do you see famly history in a cluster headache? |
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Definition
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Term
| cluster headaches occur more in |
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Definition
|
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Term
| Describe the symptoms of a cluster headache |
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Definition
Behind 1 eye Sharp and steady pain Sweating, flushing |
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Term
| What are the two thing you focus on managing migraines |
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Definition
Identify trigger facts Manage environmental changes |
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Term
| What are some trigger factors for migraines? |
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Definition
red wine Foods like chocolates and cheese Irregular sleep patterns Acutes changes in stress levels |
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Term
| Which serotonin receptors are responsible for cerebral/meningeal vasoconstriction? |
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Definition
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Term
| What is the function of Serotonin receptors 1A-F |
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Definition
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Term
| Do 5HT2 increase or decrease IP3? What does IP3 affect? |
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Definition
| Increase IP3 increasing calcium |
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Term
| What are the actions of 5HT2 |
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Definition
Vasoconstriction and vasodilation in heart/skeletal muscle Increasing platelet aggregation |
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Term
| 5HT3 affect what kind of channels |
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Definition
|
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Term
| what is the actions of 5H3 receptors? |
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Definition
| Chemoreceptor reflec (decreases HR & BP) |
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Term
|
Definition
| Vasoconstriction of the Cerebral, retinal and meningeal |
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Term
| How does vasoconstriction occur in auras? |
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Definition
| increased 5HT from platelets |
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Term
| What's the mechanism of Pulsating and throbbing that occurs in migraines |
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Definition
| There's decrease 5HT and increase PG and CGRP |
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Term
| How would a mild migraine look like |
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Definition
Occasional throbbing No major impairment of function |
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Term
| Describe how a moderate to severe migraine would present? |
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Definition
Some impairment of function Nausea |
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Term
| Which drugs do you use to treat mild to moderate migraines? |
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Definition
Aspirin Acetaminophen Ibuprofen Naproxen Aspirin, acetaminophen and caffinne Aspirin, acetaminophen w/ butalbital |
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Term
| What distinguishes a severe migraine from a moderate one? |
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Definition
more than 3 months siginificant functional impairment |
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Term
| What kind of drugs do you use to treat moderate to severe migraines? |
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Definition
Ergotamine Ergotamine and caffine Dihydroergotamine the "triptans" Butorphanol, merperidine and tramadol |
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Term
| How do Ergotamine/Dihydroergotamine work? |
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Definition
| Partial agonist of 5HT1B/1d, 5HT2 and alpha adrenergic |
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Term
| List the side effects of ergotamine/hydroergotamine |
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Definition
| Nausea, diarrhea, muscle cramps, cold skin, paresthesia, palpations and vertigo |
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Term
| What contraindictions do ergotamine/hydroergotamine have |
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Definition
| Do not use in CAD or peripheral vascular disease |
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Term
|
Definition
Sumatriptan Naratriptan Rizatriptan Zolmitriptan |
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Term
| The triptans work at which receptor? |
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Definition
| Selective agonist at 5HT1B/1D |
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Term
| Give the adverse effects of the triptans |
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Definition
Tightness of chest, muscle weakness, paresthesia, somnlence, dizziness May cause coronary vasospasm |
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Term
| When don't you want to use the triptans |
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Definition
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Term
| Name the drugs for prophylaxis |
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Definition
Methysergide Propanolol/Timolol Verapamil Valproate/Topiramate |
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Term
| What's the MOA of Methysergide |
|
Definition
5HT2 antagonist Prevents vasoconstrictive phase of migraine |
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Term
| List the adverse effects of Methysergide |
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Definition
| Ab. pain, leg muscle cramps, weight gain and hallucinations |
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Term
| Propanolol/Timolol block what? |
|
Definition
Beta adrenergic receptors |
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Term
| What advantage does Timolol have over Propanolol |
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Definition
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Term
| What kind of blocker is verapamil |
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Definition
|
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Term
| What phase of migraine headache does Verapmil prevent |
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Definition
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Term
| What class of drugs are Vaoproate/Topiramate |
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Definition
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Term
| What are the adverse effects of Vaproate |
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Definition
| Sedation, tremor, weight gain |
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Term
| What are the adverse effects of Topiramate |
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Definition
| Sedation, mental confusion and blurred vision |
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Term
| Name the antidepressants used in migraines |
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Definition
Fluoxetine Amitriptyline Phenelzine |
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Term
| What class of drugs does Fluoxetine fall in? How about Amitriypline and Phenelzine |
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Definition
SSRI Inhibit 5-HT uptake MAO I |
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Term
| What are the adverse effects of fluoxetine? |
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Definition
| Anxiety, insomnia and sexual dysfunction |
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Term
| What are the adverse effects of Amitriptyline |
|
Definition
| Drowiness, tremor and anti-cholinergic |
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Term
| What side effects does Phenelzine have |
|
Definition
| Hypertensive crisis if taken w/ foods containing tyramine |
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