MEDI7212 Lecture Notes - Lecture 15: Ketoprofen, Selective Serotonin Reuptake Inhibitor, Stress Management
Document Summary
Pharmacological management: 5-ht brain effects, hallucinations and behavioural changes, mood improvement, complex control of food intake. Sensory and pain transmission: vomiting [chemoreceptor trigger zone] - block 5-ht3-r for anti-emetic effect, abolishes sleep [low 5-ht concentration, 5-ht peripheral effects, git. Increase gi mobility - prokinetic: peristalsis, vomiting, blood, platelets - aggregation, haemostasis, vascular vasoconstriction (direct, sns) and vasodilation (endothelium dependent - no, peripheral nerve endings, stimulation of peripheral nociceptive nerve endings. Sumitriptan: triptans, migraine does not resolve after several days, rehydration + drug therapy, nausea - chlorpromazine or droperidol or prochlorperazine [iv] Stress management, cbt, manage triggers: prophylactic drugs if 2-3 migraines per month, 1st - propranolol/ metoprolol/ atenolol, amitriptyline, pizotifen (5-ht2 antagonist, 2nd - valproate, topiramate, verapamil. Non-pharmacologic management: pharmacological + non-pharmacological strategies are best to improve qol, main reasons for use, patient preference, medication. Interactions (eg ssri and tryptan: adverse drug reaction (eg tryptan, ergot)
