headache meds Flashcards
tension HA prophylaxis
TCAs, SNRIs, antiepileptics, botox
tension HA acute tx
APAP, NSAIDS, analgescs/caffeine
cluster HAs defining characteristics
conjunctival lacrimation nasal congestion eyelid edema forehead and facial sweating miosis IPSILATERAL
restlessness
cluster HA prophylaxis
galcanezumab
verapamil
lithium
topiramate
melatonin
cluster HA acute tx
O2 triptans octreotide intranasal lidocaine * dihydroergotamine corticosteroids
triptans MOA
selective serotonin receptor agonists
most commonly used triptan w most dosage foms
sumatriptan
triptans routes onset
PO - 30-60 min
nasal - 10-15 min
SC - 10 min
triptans AE
tingling, flushing, tightness/pressure in chest (related to 5-HT)
injection site pain (SC)
CI in pts with CAD/HTN
avoid w other serotonin meds, MAOIs, propranolol, CYP3A4`
ditans MOA
serotonin receptor agonist
lasmiditan dosing
50-200 mg
ditans AE
dizziness, sedation, fatigue, paresthesia, bradycardia
avoid driving for 8 h
avoid w other CNS depressants & serotonin
avoid w BCRP and P-gp substrates
gepants MOA
CGRP receptor antagonist
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rimegepant dosing
75 mg
also used for prevention
gepants AE
nausea, somnolence
avoid in CrCl <15
CYP3A4
ergotamine MAO
nonselective serotonin agonist and vasoconstrictor
ergotamine dosing
2mg sublingual
ergotamine AEs
vasoconstriction! - vascular occlusion, gangrene, vasospasm, muscle aches, N/B+V
hepatic metabolsim
dihydroergotamine has less vascoconstriction
CYP3A4, CI w ischemic heart disease, HTN, triptan use, nicotine, pregnancy
prophylaxis for migranes
beta blockers calcium channel blockers TCAs antiepileptics SSRI/SNRIs botox CGRP blockers
Indication for calcium gene-related peptid antagonist
migrane prevention
SC/IV
atogepant PO 10-30 mg
