migraine

Question 1

what is definition of migraine?

Answer 1

brain disorder characterized with moderate or severe headaches or throbbing pain on one side of head

Question 2

what is the pathophysiology of migraine?

Answer 2

due to imbalance level of serotonin cause vasodilation and activation of nociceptors result of neuropeptide release

Question 3

what is inclusion criteria for migraine?

Answer 3

• headache that moderately or severely painful
• headache pain that gets worse with physical activity
• headache that is throbbing and often worsen one side of head
• headache that cause you to miss school , work or other activities
• increased sensitivity to light, sound or smell
• long lasting headache within 4-48 hours in untreated

Question 4

what is the type of migraine

Answer 4

• migraine with aura
• migraine without aura

Question 5

what is aura ?

Answer 5

a sensory disturbance such as flashing lights, tingling , zig zags just bfr migraine attack

Question 6

what sensory experience that may occur in visual symptoms and sensory symptoms?

Answer 6

visual symptoms
- flickering lights
- spots
- loss of vision

sensory symptoms
- numbness
- needles

Question 7

what is the risk factor of migraine?

Answer 7

• genetics
• age
• women ( estrogen level )
• hormonal changes

Question 8

what can trigger migraines?

Answer 8

• stress
• changes in sleep schedule
• menstrual period
• caffeine
• alcohol
• weather changes
• diet
• dehydration
• light
• odour

Question 9

what complications that can occur ?

Answer 9

• stroke
• mental health problem

Question 10

what is non pharmacological treatment that can be used ?

Answer 10

• avoid trigger
• acupuncture
• relaxation technique

Question 11

state drug classification for acute treatment of migraine

Answer 11

• analgesic
• triptans
• ergots
  can combine within analgesic + triptans / ergots

Question 12

what is drug classification for prophylaxis of migraine?

Answer 12

• beta blocker
• TCA
• antihistamine
  ( used for prevention of migraine)

Question 13

state drug classification that can relieve symptoms of migraine?

Answer 13

• antiemetic

Question 14

state example of drug for analgesic , triptans and ergots

Answer 14

• analgesic
  ( pcm , ibuprofen, naproxen )
• triptans
  ( sumatriptan, almotriptan , zolmitriptan , rizatriptan )
• ergots
  ( ergotamine + caffeine )

Question 15

state example of drugs for beta blockers, tca and antihistamine

Answer 15

• beta blocker
  ( propranolol )
• tca
  ( amitriptyline )
• antihistamine
  ( pizotifen )

Question 16

state drug used for symptomatic relief

Answer 16

• dimenhydrinate
• metoclopramide
• prochlorperazine

Question 17

what is the side effect of triptans and ergots drug ?

Answer 17

• hot sensation
• flushing
• tightness
• dizziness
• sedation
• drowsiness

Question 18

what is the mechanism of action of triptans and ergots ?

Answer 18

both is activate 5HT receptor in brain . leads to reduce neuropeptides release. this cause less vasodilation and activation of nociceptor and improve migraine symptoms

Question 19

what if overuse of migraine drug ?

Answer 19

• cause rebound headaches

Question 20

it’s safe for pregnancy and breastfeeding?

Answer 20

no . it’s contraindication

Question 21

can triptans and ergots used together?

Answer 21

• no can cause serotonin syndrome