Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
22 Cards in this Set
- Front
- Back
What is the first phase of a migraine?
|
this is vasoconstriction of the intracrainal arteries, cause ischemic changes (aura)
|
|
what is the second phase of a migraine?
|
this is vasodilation of extracrainal arteries- this is the headache phase. this causes the pain
|
|
What are some of the vasoactive substances released in migraines
|
catecholamines, histamine, bradykinin, angiotensin, prostaglandin, GABA, CGRP (calcitonin gene related peptide)
|
|
What is Sumatriptan (imitrex) used for?
|
this is used for symptomatic treatment of migraines
|
|
What is the mechanism of action of Sumatriptan (imitrex)?
|
this is an agonist against D-subtype 5-HT1b/1d receptors.
causes vasoconstriction* of these large arteries |
|
what is the half life of Sumatriptan (imitrex)?
|
about two hours
|
|
what two routes of administration are there for Sumatriptan (imitrex)?
|
oral or sub cue
|
|
how bad are the side effects of Sumatriptan (imitrex)?
|
these are short lived and resolve on their own
|
|
When in an attack is Ergotamine tartate given?
|
this is very effective if given early in an attack
|
|
What receptors does Ergotamine tartate act on?
|
partial agonists on 5-HT
partial agonist on alpha receptors |
|
What does Ergotamine tartate do to help a migraine?
|
this is a powerful vasoconstrictor
|
|
What drugs should Ergotamine tartate be combined with in migraine therapy?
|
sedatives, and antianxiety agents
|
|
What is Dihydroergotamine used for
|
this is used to treat headaches
|
|
what is Dihydroergotamine similar to?
|
ergotamine
|
|
What is the administration method of Dihydroergotamine?
|
IV
|
|
What is methysergide (sansert) used for?
|
this is a migraine prophylatic , used to reduce frequency and intensity of severe vascular headaches
|
|
how is methysergide (sansert) given?
|
orally
|
|
What is methysergide (sansert) structurally similar to?
|
this ergot alkaloid is similar to LSD
|
|
What receptors does methysergide (sansert) stimulate?
|
weakly agonistic on 5-HT (and thus weak vasoconstriction)
|
|
What is the metabolism of methysergide (sansert)?
|
this has very high 1st pass metabolism, hepatic
|
|
What are the adverse effects of methysergide (sansert)?
|
fibrosis (lungs and retroperitoneal)
LSD like effects long term ergotism |
|
Other than Ergot alkaloids, what other drug classes are used for migraine prophylaxis?
|
b-blockers
ca-blockers antidepressants clonidine valproic acide topiramate botox |