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22 Cards in this Set
- Front
- Back
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Identify clinical features of migraine
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Prodrome
Aura Headache Postdrome |
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Symptoms of 5HT migranie
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Contraction of vascular smooth muscle (except heart & skeletal muscles)
Triphasic BP Venocontriction Increase peristalsis |
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What is the postreceptor mechanism of 5HT3
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Na+ and K+ ion channel
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5HT syndrome symptoms
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HTN, hyperrflexia, tremor, clonus, agitation, hyperthermia, coma
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TX for 5HT syndrome
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Sedation = benzos, intubation, ventilation
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What can you block the 5HT receptors when having 5HT syndrome?
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Cyproheptadine
Chlopromazine |
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Name triptan drugs
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Sumatriptan
Naratriptan and other -triptans |
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AE of triptan drugs
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Altered sensation
dizziness Muscle weakness Injection site reactions Bitter taste (nasal spray) Transient MI |
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Contraindication of triptan drugs
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HTN
Hepatic disease Renal disease Peripheral vascular disease Wolf-parkinson white |
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MOA of triptan
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5HT1D/1B agonsit
Inhibits release of 5HT |
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MOA of ergot alkaloid
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agonist, partial agonist, antagonist of
a-adernergic and 5HT2 receptors constricts blood vessels |
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What is extremely sensitive to ergot alkaloids?
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Prego uterus = causes contractions
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Indications of ergot alkaloids
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frequent, moderate migranes OR
infrequent severe ones |
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For severe migraine attacks what should use?
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IV or IM ergotamine or DHE
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What is used for chronic migraine?
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DHE
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Serious AE of ergot alkaloids?
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Peripheral ischemia causing gangrene
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Contraindications of ergot alkaloids
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CVD
PVD HTN Impaired liver and kidneys Sepsis PREGNANCY! |
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NSAID moa
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inhibition of cyclooxygenase
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Preventive/prophylactic tx for migraines
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B-blockers
Antidepressants Anticonvulsants Butterbur supplement |
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How long does it take to see benefits of B-blockes?
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3 months
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Name 2 antidepressents used for migranies
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Amitriptyline
Venlafaxine |
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Name 2 anticonvulsants used for migraines
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valproate
topiramate |
