Francisco Shared "3.41 Pharmacology of headaches" - 24 Picmonics

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3.41 Pharmacology of headaches

Cluster Headache
Presentation
More Common in Men
Unilateral Periorbital Headache
Ipsilateral Tearing
Precipitated by Alcohol
Stabbing Pain
Duration
15 min - 3 Hours
Repetitive Attacks in Clusters
Treatment
High Flow 100% O2
Ergots
Sumatriptan
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2 mins
Tension Headache
Presentation
More Common in Women
Bilateral Band-like Pain
Occipital and Neck region
Exacerbated by Stress
Exacerbated by Fatigue
Duration
> 30 Minutes
Acute Treatment
Relaxation
Caffeine
NSAIDs
Acetaminophen
Preventative Treatment
Amitriptyline
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1 min
Migraine Headaches Signs and Symptoms
Signs and Symptoms
More Common in Women
Exacerbated by Activity
Unilateral Pulsating Pain
Aura
Photophobia and Phonophobia
Nausea/Vomiting
Duration
4 hours to 3 Days
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1 min
Migraine Headache Treatments
Acute Treatment
Avoid Triggers
Sumatriptan
NSAIDs
Preventative Treatment
Beta Blockers
Calcium Channel Blockers
Amitriptyline
Topiramate (Anticonvulsants)
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1 min
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of PDA
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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1 min
Aspirin
Indications
Fever
Pain and Headache
Cardiovascular Disease (CAD)
Mechanism of Action
Irreversible inhibition of COX-1 and COX-2
Suppress Thromboxanes and Prostaglandins
NSAID
Side Effects
Reye's Syndrome
Tinnitus
Peptic Ulceration
Mixed Acidosis/Alkalosis
Nephropathy
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2 mins
Aspirin (Acetylsalicylic Acid)
Mechanism
Inhibits Platelet Aggregation
NSAID
Indications
Thrombotic Event Prevention
General Pain
Inflammatory Conditions
Fever
Side Effects
Pancytopenia
GI Ulcers
Bleeding
Considerations
Withhold Before Surgery 7-10 Days
Reye's Syndrome
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2 mins
Aspirin Poisoning (Salicylism) Assessment
Early Symptoms
Nausea and Vomiting
Tinnitus
Confusion
Hyperventilation
Respiratory Alkalosis
Late Symptoms
Metabolic Acidosis
Coma
Hyperthermia
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1 min
Reye's Syndrome
Cause
Aspirin (Salicylates) to Treat Viral Illness (In Children)
Assessment
Cerebral Edema
Lethargy (Decreased LOC)
Vomiting
Liver Failure
Interventions
Monitor for Increased ICP
Mannitol (Osmitrol)
Considerations
No Aspirin for Children
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2 mins
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
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2 mins
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly inhibits COX
Acts primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
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51 secs
Acetaminophen Antidote
Antidote
N-Acetylcysteine
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33 secs
Celecoxib
Indications
Rheumatoid Arthritis
Osteoarthritis
Pain
Mechanism of Action
NSAID
Selectively Inhibits COX-2
Side Effects
Sulfa Allergy
Increased Risk of Thrombosis
GI Bleed
Contraindication
Pregnancy > 30 Weeks
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1 min
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
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2 mins
Valproic Acid
Indications
First Line Tonic-Clonic Seizure Treatment
Bipolar Disorder
Migraine Prophylaxis
Mechanism of Action
Increases GABA Concentration
Blocks Voltage-Gated Na+ Channels
Side Effect
GI Distress
Contraindication
Contraindicated in Pregnancy
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1 min
Valproic Acid (Valproate) Side Effects
V-A-L-P-R-O-A-T-E
Vomiting
Alopecia
Liver Toxicity
Pancreatitis/Pancytopenia
Retain Fat (Weight Gain)
Oedema (Edema)
Appetite Increase
Tremor
Enzyme Inhibitor (P450)
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2 mins
Topiramate
Indications
Seizure Treatment
Migraine Prophylaxis
Mechanism of Action
Increase GABA Action
Blocks Voltage-Gated Na+ Channels
Side Effects
Kidney Stones
Weight Loss
Sedation
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1 min
Nonselective Beta-Blockers
"-olol" Suffix
Nonselective
Propranolol
Timolol
Nadolol
Partial β Agonist
Pindolol
Nonselective β with α Blocking
Carvedilol
Labetalol
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2 mins
Fluoxetine (Prozac)
Mechanism of Action
Inhibits Reuptake of Serotonin
Indications
Depression
Side Effects
Sexual Dysfunction
CNS Stimulation
Weight Changes
Serotonin Syndrome
Contraindications
No MAO-Is
No Anticoagulants / Antiplatelets
Considerations
Suicide Risk
Delayed Onset of Action
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2 mins
Calcium Channel Blockers (Verapamil and Diltiazem)
Mechanism of Action
Slows AV Conduction
Indications
Angina Pectoris
Arrhythmias
Essential Hypertension
Side Effects
Bradycardia
Hypotension
Constipation
Peripheral Edema
Gingival Hyperplasia
Nursing Consideration
Medication Education
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2 mins

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