Drugs Acting on Serotonergic Systems

Question 1

What is the MOA of the “triptans”. Name some triptan drugs.

Answer 1

5HT1d and 5HT1b receptor agonist

sumatriptan

Question 2

What are the uses of sumatriptan?

Answer 2

migraine pain/ acute migraine treatment

Question 3

S/E of sumatriptan and “triptans”?

Answer 3

possible asthenia, chest or throat pressure or pain

Question 4

What are 5HT1b and 5HT1d receptor pathways?

Answer 4

Gi coupled

Question 5

Olanazapine MOA?

Answer 5

atypical antipsychotic at 5HT2a antagonist

Question 6

Cyproheptadine use?

Answer 6

serotonin syndrome
carcinoid
other GI tumors
anorexia nervosa

Question 7

Cyproheptadine MOA?

Answer 7

5HT2 antagonist

Question 8

What does ergonavine do to the uterus?

Answer 8

causes uterine smooth muscle contraction

Question 9

ROA for ergonavine and when should it be used?

Answer 9

Give IM after placental delivery

Question 10

Ergotamine MOA?

Answer 10

partial agonist at both alpha and 5HT2 receptors in the vasculature and possibly CNS leading to vasoconstriction and helps to decrease pulsation in cerebral attacks

Question 11

Indication ergotamine?

Answer 11

acute migraine attacks

Question 12

S/E ergotamine?

Answer 12

GI distress
prolong vasoconstriction > ischemia and gangrene, abortion near term

Question 13

In addition to triptans and ergots what are some other previously discussed drugs in other chapters that can work for prophylactic treatment of migraines?

Answer 13

Beta blockers (e.g propranolol), Anti-epileptics (e.g. topiramate, valproic acid, CCBs (questionable), (TCAs e.g amitriptyline)