30 Questions
What is the primary mechanism of action of triptans in managing migraines?
Vasoconstriction and reduction of inflammation
Which of the following is a contraindication for the use of triptans?
Ischemic heart disease
What is the recommended route of administration for patients experiencing nausea and vomiting during a migraine attack?
Nasal sprays
When do the best results with triptans in managing migraine pain occur?
With early use
What adverse reaction is associated with the use of triptans?
Increased blood pressure
What potential interaction should be considered when prescribing triptans?
St. John’s wort
Which type of medication can be effective in aborting migraines if taken early?
Ergotamine preparations
What is a potential side effect of ergotamine preparations for migraines?
Nausea and vomiting
Which medication can be used for prophylactic treatment of migraines?
Antidepressants
What is a potential medical management option for an acute attack of cluster headaches?
100% oxygen
Which nonpharmacologic option can be used for the treatment of cluster headaches?
Vagal nerve stimulation
What is an acute therapy option for tension-type headaches?
Rest and relaxation techniques
What is a key patient teaching guideline for acetaminophen–aspirin–caffeine combinations?
Avoiding other acetaminophen medications
What is a key adverse effect of ergotamine?
Changes in heart rhythm
What is a contraindication for the use of ergotamine?
Hypersensitivity
How does ergotamine affect blood vessels?
Constricts cranial and peripheral blood vessels
What is a key consideration for the administration of ergotamine?
The tablet should not be crushed, chewed, or swallowed whole
What is a key factor in the metabolism of ergotamine?
Metabolized by CYP3A4 in the liver
What is the onset of action for both naproxen and naproxen sodium?
1 hour
What is the half-life of naproxen and naproxen sodium?
12 to 15 hours
What is the BLACK BOX WARNING for naproxen sodium?
Increased risk of cardiovascular events and GI bleeding
What are the contraindications for naproxen?
Known allergies to aspirin or NSAIDs, pregnancy, and lactation
What is the most frequently administered intravenous drug for migraines in emergency settings?
Ketorolac tromethamine
What is the combination of drugs that may be effective for headache treatment?
Acetaminophen, aspirin, and caffeine
What is the mechanism of action of acetaminophen?
It acts as an analgesic, but its mechanism of action is unknown.
What is the role of caffeine in the combination medication?
It increases calcium permeability in the sarcoplasmic reticulum, stimulating the CNS, cardiac activity, gastric acid secretion, and diuresis.
What are the contraindications to aspirin?
Known hypersensitivity to the drug or other anti-inflammatory agents.
Who should not receive the combination agent on an ongoing basis?
People with hepatic impairment.
What should nurses assess the patient for when administering the combination medication?
Both therapeutic effects and adverse effects.
What is the effect of the concomitant administration of caffeine and certain substances like guarana, ma huang, and ephedra?
It is not recommended.
Study Notes
Acetaminophen-Aspirin-Caffeine Combination Medication
- Acetaminophen acts as an analgesic, but its mechanism of action is unknown.
- Aspirin inhibits the synthesis of prostaglandins, which are mediators of inflammation.
- Caffeine increases calcium permeability in the sarcoplasmic reticulum, stimulating the CNS, cardiac activity, gastric acid secretion, and diuresis.
- Caffeine causes vascular constriction and increases the effectiveness of acetaminophen and aspirin by approximately 40%.
- The combination medication is used to reduce pain related to migraine or tension headache.
- Children older than 12 years may receive the adult dose of the combination agent.
- People with hepatic impairment should not receive this combination agent on an ongoing basis due to the risk of hepatotoxicity.
- Each component of the combination medication has specific adverse effects.
- Contraindications to acetaminophen include a known allergy to the drug, while aspirin has contraindications for known hypersensitivity to the drug or other anti-inflammatory agents.
- Several drug-drug interactions may occur with the combination, affecting medications such as oral anticoagulants, sulfonylureas, insulin, valproic acid, spironolactone, furosemide, theophylline, and clozapine.
- Nurses should assess the patient for therapeutic effects, including diminished pain, and for adverse effects such as hepatotoxicity, allergic reactions, fluid and electrolyte imbalance, hypoglycemia, agitation, and cardiovascular effects.
- The concomitant administration of caffeine and certain substances like guarana, ma huang, and ephedra is not recommended.
Test your knowledge about the acetaminophen-aspirin-caffeine combination medication with this quiz. Learn about its mechanism of action, indications, contraindications, adverse effects, drug interactions, and nursing considerations. Perfect for healthcare professionals and students studying pharmacology.
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