Wurpel Migraines

Question 1

What is triptains MOA ?

Answer 1

5-HT 1B/1D agonism & inhibition of CGRP release

Question 2

ADR/SE of triptans

Answer 2

NVD, dizziness, fatigue, sleepiness, muscle weakness, headache, tingling,
dry mouth, flushing, feeling hot or cold, chest pain

Question 3

5-HT1D-receptor agonist L-775,606 has less…

Answer 3

propensity towards vasoconstriction in
human isolated coronary artery (endothelium-denuded) than was mixed 5-HT1B/1D-
receptor agonist sumatriptan. The contractions produced were at concentrations where
L-775,606 would be expected to occupy 5-HT1B-receptors

when compared to sumatriptan (which activates both 5-HT1B and 5-HT1D receptors), L-775,606 (which primarily activates 5-HT1D receptors) causes less narrowing of blood vessels in isolated human coronary arteries. Even though the concentration used of L-775,606 would normally target 5-HT1B receptors, it still causes less vasoconstriction compared to sumatriptan.

Question 4

Many of the antimigraine triptans do not what ?

Answer 4

do not distinguish between 5-HT1B and 5-
HT1D receptors

Question 5

Lasmiditan is a what ?

Answer 5

serotonin 1F agonist

Question 6

MOA of dihydroergotamine

Answer 6

MOA still poorly understood but
- Alpha-antagonist/partial agonist
- 5-HT1A/1B/1D/1F partial agonist
- DA partial agonist

Question 7

ADR/SE of dihydroergotamine

Answer 7

dizziness, drowsiness, headache, NVD, flushing
(redness or tingly feeling under the skin), increased sweating, anxiety, or skin rash

Question 8

What are the CGRP antagonists and their ADR/SE

Answer 8

Ubrogepant (Ubrelvy) &
Rimegepant (Nurtec) all injectable, Erenumab (Aimovig), Eptinezumab-jjmr (Lundbeck), Fremanezumab-vfrm (Ajovy), Galcanezumab-gbun (Emgality)

SE - NVD, URI, UTI, fatigue, back pain, arthralgia