clinical neuro 3
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| receptors affected by chlorpromazine & prochlorperazine | DA, Ach, adrenergic, histaminergic
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| adverse effects of DA antagonists | poikilothermic, blurred vision, constipation, agranulocytosis, phototoxicity, EPS
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| 1 dose of sumatriptan = | aspirin + metoclopramide
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| NSAIDS most effective when | taken early on in an attack
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| benefit of nasal spray 5HT1 agonists | faster and more effective relief
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| 5HT1 agonists + DA antagonists used for | severe acute attacks
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| amidrine = | acetaminophen + dichloralphenazone + isometheptene
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| potent vasoconstrictor | isometheptene
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| analgesic, anti-pyretic, and sedative drug | dichloralphenazone
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| propanolol use | prophylactic drug for migraines
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| pizotifen use | prophylactic drug for migraines
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| MOA of pizotifen | 5HT1, 2A, & 2C antagonist, with some anti-histamine/cholinergic effects
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| side effect of pizotifen | weight gain, drowsiness, anti-muscarinic effect
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| 3 major components of theory of cortical spreading depression | correlates to visual field distrubances, mediated by release of pro-inflam neuropeptides, involves activating of trigeminal afferents from dural vasculature
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| 3 major arguments for serotonin theory | anti-migraine agents are 5HT agonists/antagonists, increased risk of attack during resperpine/fenfluramine therapy
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| triptans & ergot alkaloids are.. 5HT agonists |
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| MOA of triptans | vasoconstriction & 5HT-1 mediated inhibition of CGRP
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| not effective in migraines w/aura until after the headache has already begun | triptans
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| contraindications of triptans | CV disease and cerebrovascular disease
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| receptors acted on by triptans | 5HT 1B & 1D
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| receptors acted on by ergot alkaloids | 5HT1
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| contraindications of egot alkaloids | pregnancy, PAD, CAD, HTN, impaired renal/hepatic function
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| MOA of meteoclopramide | 5HT4 agonist, D2 antagonist, 5HT3 antagonist
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| helps w/nausea/vomitting in migraines | metoclopramide
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| adverse effects of metoclopramide | galactorrhea, constipation, EPS, tardive dyskinesia
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| contraindications for metclopramide | pheochromocytoma, PD
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| DA antagonists used to treat migraines chlorpromazine & prochlorperazine |
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| receptors affected by chlorpromazine & prochlorperazine | DA, Ach, adrenergic, histaminergic
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| adverse effects of DA antagonists | poikilothermic, blurred vision, constipation, agranulocytosis, phototoxicity, EPS
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| 1 dose of sumatriptan = | aspirin + metoclopramide
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| NSAIDS most effective when | taken early on in an attack
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| benefit of nasal spray 5HT1 agonists | faster and more effective relief
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| 5HT1 agonists + DA antagonists used for | severe acute attacks
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| amidrine = | acetaminophen + dichloralphenazone + isometheptene
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| potent vasoconstrictor | isometheptene
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| analgesic, anti-pyretic, and sedative drug | dichloralphenazone
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| propanolol use | prophylactic drug for migraines
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| pizotifen use | prophylactic drug for migraines
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| MOA of pizotifen | 5HT1, 2A, & 2C antagonist, with some anti-histamine/cholinergic effects
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| side effect of pizotifen | weight gain, drowsiness, anti-muscarinic effect
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| extremely potent vasodilator neuropeptide | calcitonin gene related peptide
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| most effecacious triptans | rizatriptan,eletriptan; sumatriptan, zolmitriptan
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| least efficacious triptans | naratriptan, frovatriptan
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| bromocriptine | ergot alkaloid
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| LSD | ergot alkaloid
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| methysergide | ergot alkaloid
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| agonists at 5HT and a1 receptors | ergot alkaloids
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| side effects of ergot alkaloids | leg weakness, muscle pain, numbness/tingling, GI issues, nausea
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| post partum hemorrhage | ergot alkaloids
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| metoclopramide | DA antagonists
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| clinical uses of chlorpromazine & prochlorpromazine | antiemetic, schizophrenia, tourette syn, huntington disease, dementia
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| butorphanol | narcotic
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| meperidine | narcotic
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| MOA of butorphanol | partial agonist @u, full agonist @k
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| administration of butorphanol | intranasal spray
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| administration of meperidine | IV
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| concern for addiction liability | oxycodone, hydrocodone, etc
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| zolmitriptan | 5HT1 agonist
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| dihydroergotamine | 5HT1 agonist
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| sumatriptan | 5HT1 agonist
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| acetaminophen + dichloralphenazone + isometheptene = | amidrine
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| MOA of amitriptyline, dothiepin, & nortriptyline | 5HT & NE reuptake inhibitors, block Na+ channels,
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| clinical uses of tricyclics | migraine prophylaxis, pain syn, chronic fatigue syn
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| may precipitate mania in bipolar pts | tricyclic antidepressants
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| clinical uses of valproic acid | generalized seizures, absence seizures, migraine prophylaxis
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| MOA of valproid acid | prolongs inactive state of Na+ channels, inhibits Ca++ channels, increases GABA
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| MOA ofgabapentin | inhibits ca++ channels
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| may be associated with withdrawl sx | gabapentin
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| MOA of methysergide | 5HT2 & 5HT1A antagonist
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| retroperitoneal fibrosis | methysergide
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| clinical uses of methysergide | migraine prophylaxis, severe refractory migraines, cluster headaches
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| migraine prophylaxis drugs | propranolol, pizotifen, tricyclic Ads, valproic acid, gabapentin, methysergide
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| drugs for acute migraines | triptans, ergot alkaloids, DA antagonists, narcotics, combination
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