59-Rheumatoid Arthritis and Migraine

Question 1

Methotrexate

Answer 1

first line treatment of RA

blocks t-cell proliferation

Question 2

Leflunomide

Answer 2

inhibits ribonucleotide synthesis. improves symptoms and slows structural joint damage

Question 3

Chloroquine and hydroxycholoquine

Answer 3

anti-malarial agents that seem to help in rheumatic disease

Question 4

Etanercept

Answer 4

cytokine receptor fusion protein. inhibits TNF-alpha

Question 5

Infliximab

Answer 5

anti-TNF chimeric monoclonal antibody

Question 6

anakinra

Answer 6

IL-1 inhibitor to treat RA

Question 7

preventive therapy of migraine drugs?

Answer 7

beta blockers: propranolol, metoprolol

antidepressant: amitriptyline
anticonvulsants: divalproex (valproic acid), topiramate

Question 8

what is a good length of treatment for migraines?

Answer 8

2-3 days to avoid “tranformation” of migraine into more severe/chronic disorder

Question 9

problems with opioids for migraine?

Answer 9

dependence/tolerance, rebound headaches, dizziness, nausea, vomiting, impaired cognitive function, risk of “tranformation”

Question 10

antiemetic drugs for acute migraines?

Answer 10

metoclopramide, chorpromazine, prochorperazine

Question 11

Ergot alkaloids

names, MOA, disadvantages

Answer 11

migraine drugs
ergotamine, dihydroergotamine
cause vasoconstriction
complex drugs with risk of vascular effects

Question 12

Sumatriptan (and other “triptans”

Answer 12

migraine drugs
serotonin receptor agonists generally safe, but mimics angina
higher cost, restrictions if CV disease