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24 Cards in this Set
- Front
- Back
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Migraine General Features
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10% of pop.
familial |
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Migraine General Features
Types 2 |
1. Without aura - 85%;
2. With aura - 15%, aura lasts for 20 min.; same symptoms as other migraine |
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Migraine General Features
symptoms |
headache
severe, unilateral, pulsating, aggrevated by light and exercise can have N&V |
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Migraine General Features
Pathophys |
Phase 1: vasocontriction and ischemia - serotonin can contributes
Phase 2: vasodilitation and pain trigeminal complex release peptides (sub P) that generate vasodilitation and inflame. stim. pain of trigeminal nerve dorsal raphe nucleus has high serotonin conc. |
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Acute Abortive Drugs
Triptans Sumatriptan Zolmitriptan Mech |
specific 5HT1B and 5HT1D receptor;
tablet forms, sc injection, nasal spray |
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Acute Abortive Drugs
Triptans Sumatriptan Zolmitriptan |
good for acute pain and N&V
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Acute Abortive Drugs
Triptans Sumatriptan Zolmitriptan Benefits |
contraction of vessels in only carotid circulation
blocks neuropeptide release and impulse conduction on trigeminal nerve (block pains) |
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Acute Abortive Drugs
Triptans Sumatriptan Zolmitriptan Disadv |
headache reoccurs more frequently (40% in 24 hrs)
paresthesia flushing, chest tightness few with coronary vasospasm |
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Acute Abortive Drugs
Triptans Sumatriptan Contraindications |
coronary disease
angina uncontrolled HTN |
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Acute Abortive Drugs
Triptans Drugs |
Sumatriptan
Zolmitriptan |
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Ergot Derivatives
Drugs |
Ergotamine with caffine (inc absorption)
Dihydroergotamine |
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Ergot Derivatives
Ergotamine with caffine Dihydroergotamine Mech |
nonspecific 5HT1A and 5HT1D and alpha and dopamine
presynaptic n. on trigeminal to prevent sub. realease and pain stim serotonin in brain stim to prevent actiation of trigeminal nerve |
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Ergot Derivatives
Ergotamine with caffine Dihydroergotamine contraindications |
obstructive vascular disease
colalgen diseases preggers HTN angina |
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Ergot Derivatives
Ergotamine with caffine tartate Features |
tablet/suppository
long lasting vasoconstriction |
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Ergot Derivatives
Ergotamine with caffine tartate Side E |
rebound heacache
N&V, diarrhea |
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Ergot Derivatives
Ergotamine with caffine tartate Overdose |
accumulation results in ergotism
parethesias of extremities, vasospasm, gangrene |
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Ergot Derivatives
Dihydroergotamine mesylate Features |
IV and IM and nasal
b.c extensive first pass metab given in office to terminate headache RAPID |
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Ergot Derivatives
Dihydroergotamine mesylate |
severe N&V (antiemnetic)
crosses BBB dorsal raphe nucleus - low recurrence rates |
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analgesics
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first line
effervescent leads to more rapid absorption |
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prophylactic treatment for migrane
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drug selection base on other medical conditions
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prophylactic treatment for migrane
beta blockers propranolol |
Used in coexisting HTN, tremor
may cause hypotension, asthma, CHF, depression |
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prophylactic treatment for migrane
AntiDepressant Amitriptyline Features |
takes 2-3 weeks
blocks serotonin prexisting fibromyalgia sedating, wt gain |
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prophylactic treatment for migrane
drugs |
AntiDepressant
Amitriptyline beta blockers propranolol |
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prophylactic treatment for migrane
AntiDepressant Amitriptyline Contraindications |
glaucoma, urinary retention, CV disease, asthma
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