KG - Pharm 3, Exam 1, Migraine Flashcards
1
Q
types of migraine?
A
- common migraine (no aura)
- classic migraine (w/ aura - aura due to reduced blood flow of posterior part of brain)
2
Q
two phases of migraine?
A
- vasoconstriction (resp for aura)
2. vasodilation & pulsation
3
Q
which drugs used for symptomatic tx migraines?
A
“-triptans”
– Sumatriptan
4
Q
Sumatriptan: moa
A
- 5-HT AGONIST ON SMALL PERIPHERY NERVES
5
Q
sumatriptan: info
A
- vasoconstriction not as strong as w/ Ergotamine
- effective 80% pts
- admin = oral, SC
- half life = 2 hrs (if another headache in 24-48 hrs, another dose needed)
- $$$
- only use if no other options
6
Q
sumatriptan: toxicities
A
b/c vasoconstrictors…
- coronary artery vasospasm
- rare arrhythmias
- angina
- transient MI
- cerebral vasospasm, hemorrhage, stroke, seizure
- peripheral vascular ischemia, BOWEL ISCHEMIA
- abd pain, bloody diarrhea, cramping
- dizziness, lightheadedness, weakness, myalgia, muscle cramps
7
Q
sumatriptan: contraindications
A
- breastfeeding
- cardiac dz
- cerebrovascular dz
- CAD
- DM
- HTN
- IV admin
- peripheral vascular dz
- pregnancy
- renal impairment
- seizures
- tobacco smoking
8
Q
Ergotamine: moa
A
- ACTS ON 5-HT RECEPTORS
- less specific than sumatriptan
- also alpha 1 stimulant
9
Q
Ergotamine: info
A
- admin = oral, sublingual, rectal, nasal
- caffeine increases absorption
- most effective if given early
- effective 50% pts
10
Q
Ergotamine: side effects
A
due to vasoconstriction….
- ACUTE = diarrhea, nausea, vomiting, cardiovascular
- CHRONIC = ergotism - vasoconstriction + CNS
11
Q
Dihydroergotamine: info
A
- admin = IV
- efficacy like sumatriptan
- adverse effect = nausea
12
Q
what analgesics given to treat migraine pain?
A
- aspirin
- acetaminophen
- naproxen
- etc…
13
Q
which beta blocker for prophylaxis?
A
propranolol
14
Q
which CCB for prophylaxis?
A
verapamil
15
Q
which antidepressants for prophylaxis?
A
- amitriptyline
- fluoxetine
