Antimigraines - Action, Pt Teaching antimigraine agents block nerve impulses in the receptors of the sympathetic nervous system.

Ergot alkaloids used in prophylaxis and treatment of vascular headaches are Adrenergic-blocking agents. Adrenergic-blocking agents dilate the veins in smooth muscle tissue in the peripheral vascular system, reducing cerebral blood flow and arterial pulsing, which reduces headache pain. Other actions include dilation of veins in uterus, increase in uterine contractions (oxytocic effect) and decrease in B/P. Process that produces migraine headaches is local dilation of blood vessels in the cranium or release of sensory neuropeptides through nerve endings in the trigeminal system, The vascualar 5-hydroxytryptamine (5-HT) receptor is present on human basilar artery and in vessels of human dura mater. Use of 5HT and serotonin, receptor antagonists results in cranial vessels constricting and blocking neuropeptides that cause inflammation, which at same time the PT fels relief of migraine headache. Adverse reactions: heart murmurs, brief tachycardia, confusion, depression, dizziness, drowsiness, fixed miosis (constriction of pupil) paresthesias ( numbnes/ tingling) weakness, nausea, vomitting, leg cramps, localized pruritus (itching), and edema, neutropenia of blood, SYMPTOMS OVERDOSE: numb, cold, pale extremeities, constant muscle pain, decreased or absent arterial pulses, drowiness, confusionm depression, confusion, hemiplegia. PT TEACHING take med as ordered. dont allow arms or legs to get cold after taking med contact DR if numbness, cold extremeities, or pain in legs occurs. oral meds upset stomach take with milk or meals to decrease. after taking med, pt lie down dark quiet room to get relief of symptoms contact dr if more than 8 mg ergotamine needed to relief migraine not used if pregnacy is suspected. ERGOTAMINE DERIVATES dihyrdoergotamine (DHE 45, MIGRANAL) alpha-adrenergic blocking agent ergotamine (ERGOMAR) Combo products (Cagerfot, Ercaf, Va-Zone) Serotonin (5-HT) receptor agonists almotriptan (Axert) naratriptan (Amerge) rizatriptan benzoate (Maxalt) * sumatriptan succinate (Imitrex) monitor B/P zolmitriptan (Zomig) Barbiturates - long duration of action, primary categoried as anticonvulsants and used for sedative effect on brain. CNS depressants, work primarily on brainstem reticular formation, reducing nerve impulses that go to cerebral cortex. depress respiratory system, and slow activity of nerves and muscles. Raise seizure threshold. to control and prevent grand mal seizures and sometimes used to treat status epilepticus. Adverse affects: drug interactions

Test Review ch. 16 & 17

signs/ symptoms PT TEACHING: Dilantin staus epilepticus: barbiturates/ hydrantons phenobarbital (type/ teach) prioity pt teach antivertigo drug