PHA 416 Exam 5 Questions & Answers 2024/2025
Meds to treat HA are vaso- (constrictive or dilatory). - ANSWERSconstrictive
Prodrome (common) premonitory HA symptoms that occur in up to 60% of pts. - ANSWERS- heightened sensitivity to light, sound, and odors
- lethargy or uncontrolled yawni...
Meds to treat HA are vaso- (constrictive or dilatory). - ANSWERSconstrictive
Prodrome (common) premonitory HA symptoms that occur in up to 60% of pts. - ANSWERS- heightened
sensitivity to light, sound, and odors
- lethargy or uncontrolled yawning
- food cravings
- mental and mood changes (eg, depression, anger, euphoria)
- excessive thirst and polyuria
- fluid retention
- anorexia
- constipation or diarrhea
Neurologic aura HA symptoms that precede or accompany HA in 10% of pts - ANSWERS- visual field
defects
- scintillating scotoma
- paresthesia (may be followed by numbness)
- "heavy" limbs without weakness
- speech/language disturbance
Clinical presentation of a common migraine must include at least 2 of what symptoms and at least 1 of
what symptoms for diagnosis? - ANSWERS2 of the following:
- localized in frontotemporal and ocular area of head
- duration of 4-72hrs (untreated)
- unilateral
- throbbing, pulsatile pain (comes on gradually over 1-2hrs)
,- moderate to severe pain
- pain intensifies with movement or physical activity
1 of the following :
- N/V
- phonophobia/photophobia
Migraine "Triggers" - ANSWERS- hormonal changes in women (menstrually associated migraine/MAM)
- foods (chocolate, aged cheeses, skipping meals)
- drinks (alcohol, highly caffeinated beverages)
- stress
- head trauma
- sensory stimuli
- changes in wake/sleep pattern
- changes in barometric pressure
- vasodilating
MIDAS - ANSWERSMigraine Disability Assessment
The general rule is to try to avoid acute treatment of more than ____ HAs per week to avoid rebound
(medication overuse headache) - ANSWERS2
How many migraine attacks need to be treated to determine efficacy of a treatment? - ANSWERS3
attacks
- switch if agent fails to control pain in 2 attacks
OTC medications for the acute treatment of migraines - ANSWERSNSAIDs (IBU, naproxen, ASA)
Excedrin Migraine
How does the caffeine present in Excedrin migraine work on HAs? - ANSWERS- cerebral vasoconstriction
,- speeds up rate of absorption of other meds so pain meds can work quicker
Action of "Triptans" - ANSWERS- 5HT1 receptor agonists
- vasoconstriction
- inhibition of mediator release
Triptans AE - ANSWERStingling, parasthesias, sensations of warmth, overuse HA
- rarely causes angina
Triptans CI - ANSWERSischemic heart disease, stroke/TIA, PVD, ischemic bowel, uncontrolled HTN,
ergotamine use within 24hrs
- cardiac workup is recommended prior to dosing in someone with multiple risk factors
An ergotamine and triptan need to be separated by how long? - ANSWERS24hrs
Which triptan is ultra fast-acting? - ANSWERSsumatriptan SQ
Which triptans are slow/long acting? - ANSWERS- frovatriptan
- naratriptan
Ergotamine MOA - ANSWERSbinds to 5HT receptor
AE of ergotamine nasal spray - ANSWERSrhinorrhea, dizziness, N/V/ medication overuse HA
AE of ergotamine injection - ANSWERSsimilar to triptans, fibrotic complications with long-term use
(pleural, retroperintoneal, cardiac valves)
Injectable ergotamine use is generally limited to what patient population? - ANSWERSemergency
room/inpatient use
, Ergotamine pregnancy category _____ - ANSWERSX
Why are ergotamines a pregnancy category X? - ANSWERScan cause uterine contractions and induce
labor
All medications used for the acute treatment of migraines can cause medication overuse headache
except _________ - ANSWERSASA
Components of Midrin - ANSWERSAPAP
isometheptene
dichloralphenazone
- removed from the market
- may be compounded
Midrin MOA - ANSWERS- APAP: inhibition of central prostaglandin synthesis, elevation of pain threshold
- isometheptene: sympathomimetic, constriction of cranial vessels
- dichloralphenazone: no well understood, sedative, relaxant
Midrin AE - ANSWERSN/V, dizziness, somnolence
What is an intractable migraine/status migrainosus? - ANSWERSdebilitating migraine lasting >72hrs
What is considered a medication overuse headache? - ANSWERS- occur >/= 15days/month
- regular overuse of a medication for > 3 months
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