RNnetwork
Study Guide
1. NEuROLOGy
A. Headaches (Migraine): These are often
caused by stress, allergies, or
environmental factors. Sufferers can
... [Show More] have
auras (a warning sign that a migraine is
imminent). Symptoms can include light
sensitivity, nausea, vomiting, and severe
throbbing pain.
• Medications and Treatments: The two
main categories of drugs used to treat
migraine headaches are for pain-relief
and prevention. Medication
management of migraine headaches
requires factoring the frequency,
severity, and degree of disability
caused.
• Pain relieving drugs: NSAIDS (Advil,
Motrin, and Aleve) are commonly used
for pain relief as well as tryptophans
(Imitrex and Axert) which also help with
nausea and light sensitivity. Ergots
(Migergot and Cafergot) are not as
effective as the NSAIDs and tryptophans;
however they are most effective in
treating pain lasting longer than 48
hours. Anti-nausea medications
(Phenergan or Compazine) are
commonly used in conjunction with the
pain relieving medications as part of the
treatment regimen. Opiates are used to
manage pain and can be habit-forming,
placing a patient at risk of addiction.
Current studies show that opiates often
cause rebound headaches, despite their
use for pain control and therefore is often
used as a last resort.
• Preventative Medications:
Cardiovascular drugs have been found
to be effective for decreasing frequency
and intensity of migraine headaches
taken on a daily/ long term basis. First
line treatments with cardiovascular drugs
are beta blockers. These drugs have
been found to be extremely effective in
reducing the severity and frequency of
headaches. Calcium
channel blockers and anti-hypertensive
medications are also very effective in
decreasing the frequency, intensity and
duration of the headache. Anti-depressants
such as tricyclic anti-depressants (Pamelor)
and SSRI’s (Effexor) are another treatment
choice for migraine headaches. Research
has shown that these medications are
effective due to affecting the levels of
serotonin and other neurotransmitters.
Medication management is guided by the
effectiveness of the treatment. The goal is to
reduce the frequency, intensity and duration
of the headache. The physician will often
combine the different medications, in order
to eradicate or greatly minimize the signs
and symptoms of migraine headaches. B.
Parkinson’s Disease: Parkinson’s disease is
a deterioration of the central nervous system
and loss of dopamine production in the
brain. Early signs include shaking, tremors,
and difficulty walking. As the disease
progresses, it begins to affect behavior and
cognitive function. Dementia occurs late in
the disease. Severe muscle spasms can
cause difficulty sitting, standing, and
severely impact the ability to walk.
• Medications and treatments: There is
no known cure for Parkinson’s disease.
The current approach for this disease is
directed at treating the symptoms that
are most bothersome. Dopaminergic
drugs are used to help replenish
dopamine levels in the brain or mimic the
effects of dopamine to reduce muscle
rigidity, improve speed, and coordination,
while decreasing tremors.
Carbidopa/Levodopa (Sinemet) is the
primary medication used for treating
Parkinson ’s disease. The brain converts
levodopa into dopamine, thereby
increasing the dopamine levels in the
brain. Due to increased levels of
dopamine, the patient
4 RNnetwork Study Guide
1. NEuROLOGy
experiences a decrease in tremors, muscle
memory loss occurs and the patient can rigidity and improved ability to walk. When
no longer recall important events such as starting this medication, it is important
anniversaries, birthdates of children, graduation for the pharmacy to check for drug
from high school, etc. Eventually the patient interactions or incompatibilities with the
no longer has the ability to recall events medications the patient is currently taking.
that occurred only minutes ago. Once the Medications are one part of the treatment
diagnosis is confirmed, the life expectancy is plan for patients with Parkinson’s disease.
approximately 7 years. Surgical procedures are available, but are reserved for patients
who, after exhausting all medication treatment regimes, still have symptoms that are not
well controlled with medication. The goal of surgery is to decrease the most debilitating
symptoms of Parkinson’s disease such as tremors, rigidity, slowed movements and
walking problems. The most common surgery performed, if needed, is Deep Brain
Stimulation. A neurostimulator device is implanted in the brain which sends electrical
stimulation to targeted areas that control movement thereby blocking abnormal
electrical signals that cause tremor and other Parkinson’s symptoms. Patients may stil [Show Less]