apap nsaids migraine

Tylenol

acetaminophen

Acetadote

acetylcysteine

Celebrex

celecoxib

Motrin

ibuprofen

Advil

ibuprofen

Mobic

meloxicam

Voltaren

diclofenac

Indocin

indomethacin

Aleve

naproxen

Naprosyn

naproxen

Toradol

ketorolac

Lidoderm

lidocaine (patch)

Imitrex

sumatriptan

Maxalt

rizatriptan

Aimovig

erenumab

Ajovy

fremanezumab

Emgality

galcanezumab

acetaminophen

Tylenol

acetylcysteine

Acetadote

celecoxib

Celebrex

ibuprofen

Motrin, Advil

meloxicam

Mobic

diclofenac

Voltaren

indomethacin

Indocin

naproxen

Aleve, Naprosyn

ketorolac

Toradol

lidocaine patch

Lidoderm

sumatriptan

Imitrex

rizatriptan

Maxalt

erenumab

Aimovig

fremanezumab

Ajovy

galcanezumab

Emgality

Non-selective NSAIDs (6)

ibuprofen (Motrin), meloxicam (Mobic), diclofenac (Voltaren), indomethacin (Indocin), naproxen (Aleve), ketorolac (Toradol)

COX-2 selective NSAID (1)

celecoxib (Celebrex)

Triptans (2)

sumatriptan (Imitrex), rizatriptan (Maxalt)

CGRP inhibitors (3)

erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality)

Treat a migraine attack in progress (2)

sumatriptan (Imitrex), rizatriptan (Maxalt)

Prevent migraines (3)

erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality)

Treats pain and fever but NOT inflammation (1)

acetaminophen (Tylenol)

Antidote for acetaminophen overdose (1)

acetylcysteine (Acetadote)

Topical anesthetic (1)

lidocaine patch (Lidoderm)

NSAID limited to 5 days (1)

ketorolac (Toradol)

Highest GI bleed risk NSAID

ketorolac (Toradol)

Lowest GI risk NSAID

celecoxib (Celebrex)

Controlled substances in this module

None

OTC brands in this module (4)

Tylenol, Advil, Motrin, Aleve

Given as a subcutaneous injection (3)

erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality)

Suffix -triptan means

Triptan, acute migraine

Suffix -mab means

Monoclonal antibody

Suffix -coxib means

COX-2 inhibitor

Celecoxib is contraindicated with which allergy?

Sulfa (sulfonamide)

Lidoderm wear schedule

Up to 12 hours on, then 12 hours off

Acetaminophen mechanism

Central COX inhibition

NSAID mechanism

Block COX-1 and COX-2, which lowers prostaglandins

Triptan mechanism

Serotonin (5-HT) agonist, constricts cranial blood vessels

CGRP inhibitor mechanism

Blocks CGRP or its receptor, stopping the migraine cascade

Lidocaine mechanism

Sodium channel blocker

Acetaminophen + alcohol

Liver failure risk

Common NSAID side effects (3)

Heartburn, higher blood pressure, fluid retention

Serious NSAID risks (3)

GI bleed/ulcer, heart attack/stroke, kidney failure

NSAIDs + blood thinners or antiplatelets

More bleeding

NSAIDs + blood pressure meds

Weaker blood pressure control

Triptan contraindications (2)

Ischemic heart disease, uncontrolled hypertension

Triptans + SSRIs, SNRIs, MAOIs, or ergots

Serotonin syndrome

Common triptan side effect

Dizziness

Serious triptan risks (3)

Heart attack, serotonin syndrome, severe hypertension

Common CGRP inhibitor side effect

Injection-site pain

Rare serious CGRP inhibitor risk

Anaphylaxis

Lidocaine overuse or use on broken skin

Seizures, arrhythmia