Anti Migraine Flashcards
ergot vs triptans on where they work
ergot: agonist of serotonin, alpha, beta, and dopamine
triptans: selective for only serotonin
how do these drugs treat migraines
constricts intracranial pressure
(vasodilation=migraine)
how does erenumbab work
by blocking CGRP which causes vasodilation
what is erenumab
a monoclonal antibody (-mab)
given once a month for prevention
injectable
ergot side effects
n/v due to CTZ trigger
paresthesias
ergotism (necrosis in digits due to poor circulation)
alpha receptors cause vasoconstriction
who should we avoid ergots in
HTN
CAD
peripheral vascular disease
pregnancy (stimulates uterine muscle)
triptans side effects
way less N/v due to these drugs being selective
chest symtoms: feels like an MI due to the constriction of cornaries
special considerations for triptans and ergots
do not use within 24 hours of each other
do not use within 2 weeks of MAOI (monoamine oxidase inhibitor)
rebound headaches vs overuse headaches
rebound: effect of drug wearing off and headache comes back
overuse: due to using a drug too often and relying on the drug too heavily, leading to dependence (causing own headache)
how to minimize risks of overuse
limit ergot and triptan to 2-3x week and alternate the medication
triptan drugs
rizatriptan
sumatriptan
all migrane drugs cause what
vasoconstriction
why do ergot cause cold, numb, painful extremities and decrease peripheral pulses
since alpha are activated this causes vasoconstriction through whole body
avoid what with ergot
verapamil and diltiazem
