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16 Cards in this Set
- Front
- Back
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moa of the -triptan drugs?
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5HT1 Receptor Agonists
Mechanism and pharmacological effects – 5HT1D/5HT1B receptor agonists which constrict large cranial blood vessels, decrease inflammation around sensory nerves, and inhibit trigeminal neuronal discharge. These actions relieve pain and other symptoms of migraine |
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what are the long acting -triptan drugs?
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frovatriptan
naratriptan -good for outlasting long headaches note: these also take longer to start working Narrate Frodo's Long Trip |
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most common side effect of the triptans? Who are they contraindicated in?
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Nausea and vomiting most common after oral administration.
Pain and redness at injection site plus tingling, dizziness, burning sensations, tightness and pressure in the chest. Contraindicated in patients with coronary artery disease and angina. (will hit 5HT2 receptors on coronary vasculature) |
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why should triptans be avoided in pts on SSRIs?
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triptains affect serotonin (5HT1D/B)
Possibility of serotonin syndrome in patients also taking SSRIs |
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what is the MOA of Ergotamine and Dihydroergotamine?
how does this help with migranes? how is it different from the triptans |
Ergotamine binds to all subtypes of 5HT1, and 5HT2 receptors as well as adrenergic and dopaminergic receptors. Agonist activity at 5HT1B and/or 5HT1D receptors on cerebral blood vessels probably responsible for anti-migraine activity.
SIDE EFFECTS are really bad-Nausea vomiting, muscle weakness, numbness/tingling in fingers and toes, allergic rxn, chest pain note: caffeine can help with absorption |
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Cafergot plus CYP3A4 inhibitor (macrolides, protease inhibitors) may do what?
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fatal ischemia
cafergot--Ergotamine+Caffeine |
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which b-blockers can be effective for tx of migraine?
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propranolol
timolol |
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what antiepileptic drug can be good to treat migraine?
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Valproate
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Amitriptyline can be used to treat?
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Migraine
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SSRI is a good treatment for what type of headache?
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menstrual migraine
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how can montelukast be used to tx migraine?
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decrease frequency by decreasing inflammation
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pt has:
Occasional throbbing headaches and No major impairment of functioning stage of migraine? Therapies? |
stage of migraine: Mild
Therapies: Mild analgesics (NSAID) Combination analgesics Antiemetics, depending on severity |
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pt has:
Moderate or severe headaches, Some impairment of functioning, and Nausea stage of migraine? Therapies? |
stage of migraine: Moderate
Therapies: Combination analgesics Triptan or Ergot alkaloid Antiemetics |
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pt has:
More than 3 severe headaches a month , Significant functional impairment, and Marked nausea and/or vomiting stage of migraine? Therapies? |
stage of migraine: Severe
Therapies: Triptan or Ergot alkaloid (+/- NSAIDS) Prophylactic medications (Topiramate) Antiemetics |
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first line treatment for acute cluster headache?
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Fast acting triptan (nasal or SC) or oxygen are the first choices
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prevention tx for cluster headaches?
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Verapamil is drug of choice; melatonin may be effective
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