Headache drugs Flashcards
Triptans
Sumatriptan, Solmitriptan, Rizatriptan, Naratriptan, Eletriptan, Almotriptan, Frovatriptan
Other Abortive agents
Dihydroergotamine, analgesics, NSAIDs, compound preparations, Narcotics
Caffeine
antagonizes adenosine receptors
Fiorinal
Butalbital, aspirin, caffeine
Fioricet
Butalbital, acetometaphin, caffeine
Fiorinal/Fioricet indications
tension headaches
Fiorinal/fioricet ADR
nausea, abdominal pain, drowsiness, dizziness
Triptan MOA
serotonin receptor agonists. 5-HT receptor found on cranial arteries, basilar artery, and dura mater vasculature. Mediates vasoconstriction
Triptan indications
acute migraine with or without aura
Triptan uses
moderate to severe migraine, mild to moderate migraine that doesn’t respond to NSAIDs
Triptan contraindications
basilar migraine, ischemic cardiac, cerebrovascular, or peripheral vascular syndromes, uncontrolled HTN, liver disease
Triptan ADR
coronary artery vasospasm, transient myocardial ischemia, myocardial infarction, ventricular tachycardia Vfib, HTN, parasthesias, fatigue, flushing, chest tightness, sweating
Ergot Alkaloids
Ergomar (ergotamine tartrate), Cafergot (Ergotamine and caffeine), dihydroergotamine
Ergot MOA
nonselective 5HT receptor 1 agonists. direct stimulating effect on peripheral smooth muscle and cranial blood supply. Vasoconstrictor
Dihydroergotamine MOA
5HT, NE, and DA receptors
Dihydroergotamine indications
acute migraine, cluster HA
Ergot indications
abort or prevent vascular HA
Ergot contraindications
Renal failure, hepative failure, vascular disease, HTN, pregnancy, breastfeeding, basilar or hemiplegic migraine
Ergot ADR
St. Anthonys fire (HA, vomting, diarrhea, gangrene), ischemia (P450), abd pain, weakness, fatigue, myalgia, diarrhea, chest tightness
Ergot drug interactions
other ergots, serotonin, p450 3A4 inhibitors, vasocontrictors
Migraine prophylaxis
Divalproex sodium, Topiramate, Propranolol, Metoprolol, Timolol, Frovatriptan
Natural Medicines
Butterbur
