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10 Cards in this Set
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- Back
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Erogotamine Tartrate (Ergomar)
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Acute for severe migraine
oral, sublingual, suppository don't exceed 6mg/ attach or 10 mg/wk vasocontricts up to 24 hr Caffeine - vasoconstrict + improve GI absorption metabolized liver --> excreted in bile DIRTY DRUG= interacts w/ serotonin, dopamine, and adrenergic receptros mediates via activation of 5-HT1B and vasoconstriction and reduce neurogenic inflamation DON'T USE IF: peripheral vascular disease, GI upset due to trigger chemoreceptor zone, CV disease, sepsis, liver and kidney disease, pregnancy, breast feeding Drug-drug: erythromicin |
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Dihydroergotamine (D.H.E.45)
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acute treatment of moderate - severe migraine
metabolized liver excreted in feces incompletely absorbed via GI- administered peripherally and nasally MOA: vasoconstriction intracranial arteries, decreased inflammation via decrease neuropeptide transmitters DIRTY DRUG: GI upset, vasospasms due to more alpha blocking activity Contraindicated if CV, kidney, or liver disease, arterial insufficiency, pregnant/breast feeding |
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Sumatriptan (Imitrex)
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Acute treatment of moderate to severe migraine
derivative of serotonin 5HT SQ, oral, nasal spray metabolized by MAO-A - excreted in urine MOA: constriction of inflamed/dilated intracranial arteries and by inhibiting the release of vasodilators/ proinflammatory mediators and relieves n/v, photophobia and phonophobia Give w/in 24 hrs ADR: CV: severe MI - fatalities, chest and throat tightness, difficulty breathing, panic/anxiety, paresthesias, feeling of heaviness C/I: coronary artery disease, MOA-I use NOT IV |
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Prochlorperazine (Compazine)
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Dopamine agonist
treatment of acute migraine relieve H/A pain and anti-emetic IM or IV |
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Methysergide (Sansert)
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metabolized to methylergometrine
oral administration 5HT2 receptor antagonist and 5Ht1 receptor agonist prophylactic treatment takes 1-2 days ADR: fibrosis and fibrotic complications - need drug holiday Cardiovascular - angina pectoralis GI, CNS- lsd effects, allergy C/I: CVD, fibrotic disease, impaired renal/ liver, peptic ulcer, serious infection, pregnant women and children |
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Beta-blockers (Propanolol, timolol, atenolol, metropolol, nadolol)
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lack ISA activity most effective prophylactic treatmetn
ISA= NOT effective ADR: Fatigue, cold extremities, dizziness, CNS side effects, nadolol and Atenolol less CNS, impotenence |
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Antidepressants- Amitriptyline (Elavil)
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MOA: down regulation of central 5HT2 and adrenergic receptors
Side effects: anticholinergic effects |
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Antiseizure Drugs - Valproci acid: Valproate sodium 1:1 (Depakote)
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MOA: facilitating GABA neurotransmission modulating glutamate and inhibiting sodium and calcium channel activity
Side effects: n/v, weakness, somnolence, wt gain, tremor, hair loss, and hepatic toxicity C/I - liver disease, thromocytopenia - monitor platelets and liver blood parameters, neural tube defects |
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Anticonvulsants: Gabapentin (Neurtonin) and Topiramate (Topamax)
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migraine prophylaxis
T, ADR: paresthesia, fatigue, anorexia, diarrhea, wt loss, memory problems, and nausea G, ADR: somnolence, asthenia, and dizziness |
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Zolmitriptan (zomig, Zomig ZMT)
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second generation triptan
greater bioavailability than first generation act at the peripheral components of the trigeminovascular system centrally inhibit pain treansmission in trigeminal nucleus oral, nasal, and disintegrating |
