Exam 2: Pharmacotherapeutics for Advanced
Practice Nurse Practitioners Exam Questions
With Correct Answers
What are commonly used abortive therapies for a headache? - answer✔-OTC analgesics
-Ergot Derivatives
-Triptans
-Antiemetics
Which OTC analgesics are recommended for management of headaches? - answer✔-Aspirin
-Tylenol
-Ibuprofen
-Naproxen
-Excedrin Migraine
-Advil Migraine
How does aspirin play a role in management of HA? - answer✔-anti-prostaglandin
-antiplatelet
-serotonergic activity
How do NSAIDs play a role in management of HA? - answer✔inhibits prostaglandin synthesis
for central analgesia effects
How do ergot derivatives help manage HA? - answer✔Vasoconstriction to decrease pulsation in
extra cranial arteries without reducing cerebral blood flow
What are some factors that prevent a provider from prescribing Ergotamine? - answer✔-Extreme
nausea & vomiting
-Unpredictable oral absorption
How many doses per week of Ergotamine can be used? Per month? - answer✔-2/week
Ergotamine is contraindicated in which patients? - answer✔Pregnant & children
Why might dihydroergotamine (DHE) be prescribed over Ergotamine and who might be a better
candidate for it? - answer✔Less vasoconstrictive effects
*May be better alternative for patients with peripheral vascular disease
How do triptans influence HA pain? - answer✔vasoconstriction & blockage of pain pathways to
brainstem
Why would a provider prescribe a different triptan if one is not effective? - answer✔They each
have slightly different onsets & 1/2 lives
What are contraindications to prescribing or administering a triptan? - answer✔-CAD,
uncontrolled HTN
-within 24 hours of an ergot derivative
-within 2 weeks of MAOI or SSRI
What are considerations a provider should take when prescribing antiemetics for a patient
experiencing HA/migraines? Why? - answer✔Route of administration
*Nausea & vomiting associated with episode leads to decreased gastric emptying and decreased
oral absorption of medications
What are preventative therapies for the management of HA/migraines? - answer✔-beta blockers
-antidepressants
-antiepileptics
-NSAIDs
-Ca channel blockers
-ACE inhibitors & ARBs
-Botulinum Toxin (A)
What is the first beta blocker that you would prescribe for preventative management of
HA/migraine? - answer✔Propranolol
How long should a patient be monitored for after initiating a beta blocker for treatment of
HA/migraine? What should be monitored? - answer✔-3 months
-Blood pressure & heart rate
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