Migraine

Question 1

Which natural products can you use for migraines?

Answer 1

1. Caffeine (w/ or w/out apap or ASA) - treatment

Following are tried for prevention:
2. Butterbur
3. Feverfew
4. Mag
5. Riboflavin
6. Topical peppermint
7. CoQ10

Question 2

Name Triptans

7

Answer 2

1. Almotriptan (Axert)
2. Eletriptan (Relpax)
3. Frovatriptan (Frova)
4. Naratriptan (Amerge)
5. Rizatriptan (Maxalt)
6. Sumatriptan (Imitrex)
7. Zolmitriptan (Zomig)

Question 3

Which triptans are available ODT?

Answer 3

Zomig, Maxalt
zolmitriptan, rizatriptan

Question 4

Which triptans are available as a nasal spray?

Answer 4

Zomig, Imitrex

Question 5

What forms does Sumatriptan come in?

Answer 5

1. Tablet
2. SQ autoinjector (Imitrex, Zembrace Symtouch)
3. Prefilled syringe
4. Nasal spray (Tosymra, Imitrex)
5. Nasal powder (Onzetra Xsail)

Question 6

What are contraindications of triptans?

Answer 6

1. Stroke/TIA
2. Uncontrolled HTN
3. Ischemic heart disease
4. PVD
5. Hx of hemiplegic or basilar migraine
6. Use within 24 hours of another triptan or ergotamine

Question 7

What are warnings of triptan use?

Answer 7

1. Heart related (BP increase, arrythmias)
2. Serotonin syndrome
3. Seizures
4. Med overuse HA
5. Caution in renal & hepatic impairment

Question 8

What are side effects of triptans?

Answer 8

1. Nerve related: Paresthesia (tingling/numbness), Hot/cold sensations
2. CNS: Dizziness, somnolence
3. GI: nausea
4. Heart: CP/tightness
5. Anticholinergic: dry mouth

Question 9

Which triptans are CI with MAOI?

Answer 9

Imitrex, Maxalt, Zomig