HA- Triptans DI Flashcards
Triptans used in migraine treatment
Almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
Triptan indication
ACUTE treatment of moderate-severe migraine
MoA of triptans
5-HT1D and 5-HT1B selective agonists
causes vasoconstriction and reduces inflammation associated with antidromic neuronal transmission
Triptan ADEs
Flushing, chest pain, palpitations, dizziness, fatigue, xerostomia, serotonin syndrome
Sumatriptan ADEs (she talked about them in lecture)
chest tightness and pressure, SOB, palpitations, anxiety
ADEs of sumatriptan are more likely to occur with which formulation of it?
SQ, but resolves after 30 minutes
Triptan CIs
Hemiplegic migraine or migraine with brainstem aura
Known/suspected heart disease or other underlying CVD
Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
Stroke, TIA
Peripheral vascular disease
Uncontrolled HTN
Use within 24 hours of an ergot or different triptan
MAOIs (rizatriptan, sumatriptan, zolmitriptan)
MAOIs are CI’ed with use of what triptans?
Rizatriptan, sumatriptan, zolmitriptan
How many days/month can you use a triptan in order to prevent development of medication overuse HA?
<10 days/month
Use triptans with caution in what patients?
Elderly/older adults
What can you use with triptans?
NSAIDs
Results of the Hall et al. 2004 retrospective study
People with less CV risk were prescribed triptans
Results of the Velentgas et al. 2004 retrospective study
People with migraines that had a Hx of CV or cerebrovascular events in the last year prior to the cohort entry were excluded; migraineurs have increased stroke risk compared with people who don’t have migraines
Results of the Albieri et al. 2016 cohort study
No information on non-triptan migraines were included; migraineurs using triptans were at an increased risk for ischemic and hemorrhagic stroke but the risk didn’t seem to be related to triptan use
Triptan with the longest haf-life
Frovatriptan
