Drugs-Migraine Flashcards

1
Q

Classes of drugs for migraine PROPHYLAXIS

A
  1. Anti-hypertensives (beta blockers, ca+2 channel blockers)
    - Propranolol
    - Verapamil
  2. Anti-depressants
    - Venlafaxine (SNRI)
    - Amitryptilline (TCA)
  3. Anticonvulsants
    - Valproate
    - Topiramate
  4. CGRP Antibodies
    - Erenumab (receptor)
    - EFG.. zumab (CGRP itself)
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2
Q

Classes of drugs for migraine Abortion

A
  1. CGRP Releasing Inhibitors (5-HT 1B/1D Agonists)
    - Triptans
    - Ergotamines
    - Ditans
  2. CGRP Antagonists
    - …gepant
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3
Q

MOA for Triptans

A

Vasoconstriction to reduce meningeal blood flow (5HT-1B/1D agonism)

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4
Q

Toxicities of Triptans

A

Triptan syndrome

Paresthesia
Chest/Neck Pain
Flushing

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5
Q

Since CGRP releasing inhibitors are serotonin receptor agonists, Triptans should not be used with what medications for the risk of Serotonin Syndrome?

A

Ergotamines

MAOIs

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6
Q

What NTs are considered monoamines?

A

Dopamine
Serotonin
NE

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7
Q

MOA for Dihydroergotamine

A

Vasoconstriction to reduce meningeal blood flow (5HT-1B/1D agonism)

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8
Q

What acute/abortive migraine drug is pregnancy category X?

A

Dihydroergotamine

  • can induce uterine contraction!
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9
Q

Toxicities of both Triptans & Dihydroergotamine

A
  • Temporary spike in BP
  • MI
  • Stroke
  • due to vasoconstriction
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10
Q

B/c of their toxicities, Triptans and Dihydrogergotamines are contraindicated in patients with

A
  • CAD
  • HTN
  • Hx of MI/stroke
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11
Q

Ditans don’t cause toxicities that of Triptans & Dihydroergotamines b/c

A

They don’t directly induce vasoconstriction

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