Drugs for Pain Opiods and Headaches-pharm

Drugs for Pain Opiods and Headaches-pharm

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Unformatted text preview: Receptor Agonists Serotonin Sumatriptan Sumatriptan •Adverse effects • Chest symptoms – Transient “heavy arms” or “chest pressure” experienced Transient by 50% of users • Coronary vasospasm – Rare angina secondary to vasospasm • Teratogenesis • Others – – – Vertigo, malaise, fatigue, tingling sensations Very bad taste when taken in intranasal form Don’t need to know Don’t Serotonin1B/1D Receptor Agonists Serotonin Other serotonin1B/1D receptor agonists – – – – – – Zolmitriptan Naratriptan Rizatriptan Almotriptan Frovatriptan Eletriptan (Zomig) (Amerge) (Maxalt) (Axert) (Frova) (Relpax) Migraine Headache III Migraine • Beta blockers- “olol” – – – Preferred drugs for migraine prevention Preferred migraine Slow heart rate and blood pressure Slow Opposite of triptans Opposite • Tricyclic antidepressants • Antiepileptic drugs – Divalproex (Depakote ER) – Topiramate (Topamax) • Estrogens and Triptans(for menstrual Estrogens migraine) frovatriptan or eletriptan migraine) Migraine Headache III Migraine • Other drugs for prophylaxis – Calcium channel blockers (verapamil) – Candesartan, an angiotensin II receptor blocker Candesartan, (ARB) (ARB) – Supplements: herbal Supplements: • • • • Riboflavin or B2 Coenzyme Q-10 Feverfew Butterbur Cluster Headaches Cluster • Characteristics – Occur in a series or “cluster” of attacks Occur “cluster” – Each attack lasts 15 minutes to 2 hours – Severe, throbbing, unilateral pain near the eye – Vasodilation occurs resulting in release of serotoin and Vasodilation histamine. histamine. – Lacrimation, conjunctival redness, nasal congestion, Lacrimation, rhinorrhea, ptosis, miosis on the same side of the headache headache – 1-2 attacks every day for 2-3 months – An attack-free interval of months to years separates An each cluster each • Treatment – Primary therapy directed at prophylaxis Treatment of Cluster Headaches Prevention: •Prednisone- steroid •Verapamil •Lithium Treatment: •Sumatriptan subQ •Oxygen Tension Headache • Most common type of headache. • Associated with pericranial muscle spasm which causes decreased blood flow and muscle ischemia. Serotonin levels may be decreased. • Episodic nonpulsating mild to moderate headache with or without neck muscle pain and tenderness. • Usually bilateral and not associated with nausea or photophobia. Pain is dull and persistent with varying intensity. Occur frequently. • May be associated with psychosocial stressors. • Treatment---nonopioid analgesics and patient Treatment---nonopioid teaching on how to manage stress. teaching Critical Thinking Question Tom complains of having migraine headaches two to three times per month, and tells you that the pain incapacitates him for hours (severe). He wants to try sumatriptan (Imitrix) because his friend has found it helpful. How should Tom be assessed before this medication is prescribed? If he does receive a prescription for this medication, what teaching needs wil...
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This document was uploaded on 03/25/2014.

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