Anti-migraine Agents Flashcards
Use of anti-migraine agents across the lifespan: CHILDREN
- anti-migraine medication’s aren’t generally recommended for children
- Treat first with over-the-counter analgesics
- Need to be evaluated for other causes of headache
Triptans are only approved for children 6 yrs or older
Use of anti-migraine agents across the lifespan: ADULTS
-Adults also need to be a evaluated for the reason of their headache
- Ergots and tripans are contraindicated in pregnancy
- Alternative methods to feed baby
Use of anti-migraine agents across the lifespan: OLDER ADULTS
- Ergot derivatives and triptans can exacerbate cardiovascular effects, and renal or liver problems in patients with those pre-existing conditions like kidney failure, hypertension, CAD, and liver failure.
- Take the least amount of drug as possible
- Monitor closely for cardiovascular effects
Must report any sort of chest pain or cardiovascular changes immediately
Drug class: Ergot derivatives
What are the drug or suffixes in this class?
-Ergotamine
-Dihydroergotamine
Drug class: Ergot derivatives
What is the action?
Block alpha-adrenergic and serotonin receptor sites in the brain to cause constriction of cranial vessels, decrease in cranial artery pulsation, and decrease in hyperfusion of basilar artery bed.
(Work by decreasing the pressure in the brain by constructing the vessels and by decreasing the size of the vessels in the brain)
* by decreasing the size of the vessels, we alleviate the pain
* work by decreasing the throbbing pain
Drug class: Ergot derivatives
What are the indications?
-used to prevent migraine or vascular headaches
Dihydroergotamine is also approved for the treatment of cluster headaches.
Drug class: Ergot derivatives
What are the contraindications?
if patients already have coronary artery disease, hypertension, or peripheral vascular disease, get ergot derivatives their conditions can be exacerbated because we are giving them a vasoconstricting agent when they already have vessel construction, or reduced blood flow
- Know allergy
-Altered liver function can lead to poor metabolism of the drug, and these drugs should not be given to pregnant or lactating patients.
(Ergotism = S/S of vomiting, diarrhea, and seizures)
Drug class: Ergot derivatives
What are the cautions?
Pruritus (itching) - can become worse with vasoconstriction
Malnutrition - ergot derivatives activate the chemo trigger zone which causes worsening of G.I. symptoms and thus worsening malnutrition.
Drug class: Ergot derivatives
What are the adverse effects?
all the adverse effects are related to the vasoconstricting properties of egot derivatives
-numbness, tingling of extremities, muscle pain
-pulselessness, weakness, chest pain, arrhythmias
-nausea, vomiting, diarrhea
Drug class: Ergot derivatives
What are the drug-drug interactions?
-Beta blockers (combined with ergot derivatives,increased risk of gangrene and peripheral ischemia)
-Tripans (combined with ergot derivatives can cause vaso spasms)
Drug class: Triptans
What drugs or suffixes are in this class?
“Triptans”
- Eletriptan
- Sumatriptan
- Zolmitriptan
Drug class: Triptans
What is the action?
Cause cranial vascular construction and relief of migraine, headache, pain in many patients.
Drug class: Triptans
What is the indication?
Treatment of acute migraine and are not used for prevention of migraines.
Taken after a migraine has started
Drug class: Triptans
What are the contraindications?
-Know allergy
-Pregnancy
-Coronary artery disease (can become worse with vasoconstriction)
patients who are at increased risk of coronary artery disease should be monitored closely
Drug class: Triptans
What are the cautions?
- Elderly (older adults are more likely to have risk factors or coronary artery disease and renal or liver problems)
- Risk factors for coronary artery disease’
- Lactation
- Renal and hepatic function
