migraine

Question 1

limit abortive treatment to _____

Answer 1

less than 2-3 days per week

Question 2

mild-moderate abortive treatment

Answer 2

NSAID, acetaminophen

Question 3

moderate-severe abortive treatment

Answer 3

triptans/ergots

Question 4

when do we need preventative therapy

Answer 4

4 + attacks per month with disability at least 3 x per month
about 1 migraine a week

Question 5

first line abortive

Answer 5

tripatns and nsaids

Question 6

second line abortive

Answer 6

nsaids (ketoroloac, ketoprofen)

Question 7

preventative tx first line

Answer 7

valproate
topiramate
metoprolol
propranolol
frovatriptan

Question 8

preventative second line

Answer 8

amitrypyline

Question 9

contraindications to triptans

Answer 9

use of ergot/triptan within 24 h
use of MAOi within 2 weeks
heart disease, angina, stroke,HTN, ischemic bowel disease, hepatic impairment

Question 10

triptans warnings

Answer 10

MI
pain in chest, throat, neck
headache
serotonin syndrome
seizures

Question 11

which triptan has caution with sulfa allergy and corneal opacities

Answer 11

almotriptan

Question 12

triptans side effects

Answer 12

oral tingling, drowsiness, fatigue, chest tightening, flushing

Question 13

triptans drug interactions

Answer 13

SSRIs/SNRIs

Question 14

eletriptan drug interaction

Answer 14

3A4 inhibitors

Question 15

ergot side effects

Answer 15

fibrosis, cold in extremtities, numbness

Question 16

ergot warning

Answer 16

peripheral ischemia, fibrosis, vasoconstriction, cerebrovascualr events

Question 17

drug interactions ergots

Answer 17

3A4s

Question 18

calcitonin gene related peptide antagonists (CGRP)

Answer 18

abortive treatment
- rimegepant
- ubrogepant
- zavegepant

Question 19

CGRP drug interactions

Answer 19

strong 3a4 inhibitors , DO NOT GIVE
pgp inhibitors

Question 20

lasmitidan warnings

Answer 20

headaches, sedation, serotonin syndrome, driving impairment

Question 21

which drug should you avoid driving for 8 hours after dose

Answer 21

lasmiditan

Question 22

monitoring with lasmiditan

Answer 22

LFTs, BP, HR

Question 23

rescue nasal spray med for abortive migraines

Answer 23

butorphanol

Question 24

beta blockers for preventative therapy with doses

Answer 24

propranolol - 80-240 mg daily
metoprolol - 100-200 mg daily

Question 25

beta blockers contraindicated in ___

Answer 25

reynauds and asthma

Question 26

which drugs not FDA approved for preventative

Answer 26

tricyclic antidepressants

Question 27

amitryptyline dose preventative tx

Answer 27

25-150 mg daily

Question 28

atogepant side effects

Answer 28

nausea, constipation, fatigue

Question 29

rimegepant

Answer 29

nausea, rash, dyspnea

Question 30

valproate dosing preventative

Answer 30

500-1500 mg daily

Question 31

topiramate dosing preventative

Answer 31

50-100 mg daily

Question 32

natural product for migraines

Answer 32

butterbur/pesasites
150 mg/day

Question 33

contrainidcation in pregnancy

Answer 33

ergots
valproate

Question 34

warning in pregnant

Answer 34

triptans
topiramate

Question 35

12 and older abortive therapy

Answer 35

alotriptan
sumatriptan/naproxen combo
zolmitriptan nasal spray

Question 36

6 and older abortive therapy

Answer 36

rizatriptan

Question 37

is sumatriptan spray fda approved in children?

Answer 37

no
efficacy in 6 older tho

Question 38

12 and older prophylaxis

Answer 38

topiramate