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Flashcards in migraine Deck (22):
1

two classes for migraine tx

1) acute tx
2) prevention

2

mild to moderate migraines

non-opioids
acetaminophen
NSAIDs

3

mod to severe migraine DOC

triptans

4

triptan

agonist 5 HT1D/1B

5

triptan AE

vasoconstrictors: so contraindicated in coronary/cerebrovascular disease

vasospams can occur - chest tightness

6

ergotamine/dihydroergotamine

agonist at alpha, 5HT, D2

7

prevention of migraines 1st line (3)

beta blockers
valproate
topiramate

8

2nd/3rd line prevention migraines

TCA
SNRIs
CCB
gabapentin
ACEI/ARB
botulinum
NSAIDs

9

beta blockers used in migraines (first line)

atenolol
timolol
nadolol
metoprolol
propanolol

10

valproate MOA

block Na and T type Ca VG channels

11

topiramate MOA

block VG Na. Antagonist at GABA(a) and glutamate receptor

12

TCAs used in migraine tx

amitryptaline
nortryptiline
imipramine

13

SNRIs used in migraine tx

venalfaxine

14

CCBs used in migraine tx

verapamil: greatest efficacy of CCBs
gabapentin - dec glutamate release

15

ACEIs and ARBs used in migraine tx

lisinopril
candesartan

16

NSAIDs used in migraine tx

naproxen, ibuprofen
for frequent but mild migraines

17

ergot alkaloids AE

n/v
vascular occlusion with gangrene in OD cases
dihydroergotamine = weaker vasoconstricter, less AE

contraindicated in arterial dz or uncontrolled HTN

18

valproate AE

GI, thrombocytopenia, teratogenic

19

topiramate AE

somnolence, fatigue, cognitive slowing, acute myopia, glaucoma, hyperthermia, renal stones
teratogenic

20

TCA AE

sedation
dry mouth
weight gain

21

TCA MOA

inhibit NE and serotonin reuptake

22

venlafaxine AE

nausea, constipation, insomnia, sexual dysfunction