Migraine

Question 0

Propanalol/Inderol

Answer 0

non-selective beta blocker for migraine prophylaxis

po 10-100 mg/day

Question 1

vessels and serotonin during migraine

Answer 1

Before headache- vasoconstriction and high serotonin

during headache- vasodilation and low serotonin

Question 2

Amitriptyline/ Elavil

Answer 2

Tricyclic antidepressant for migraine, bipolar
Modulates serotonin and NE in CNS
sides: dizziness, drowsiness, constipation, blurred vision

Question 3

Topiramate/Topamax

Answer 3

Anticonvulsant used for epilepsy or prophylaxis of migraines
Blocks sodium channels in CNS and augments GABA
Sides: vision changes and acute angle glaucoma

Question 4

Methysergide/ Sansert

Answer 4

Ergot derivative- serotonin 2 antagonist for headache prophylaxis
appears to cause vasoconstriction
never use for longer than 6 months
side: htn, thrombophlebitis, pulmonary fibrosis, heart valve thickening. Cat x

Question 5

Sumatriptan/Imitrex

Answer 5

Serotonin agonist for migraines and cluster headaches (prodomal phase med)
side: dizziness, tingling, facial flushing, arrythmia
serotonin syndrome

Question 6

serotonin syndrome

Answer 6

agitation, tremor, ataxia, fever, chills, diarrhea

Question 7

Butorphanol/Stadol

Answer 7

opioid analgesic for migraine that is refractory to triptans
can be a nasal spray or IM
has a dependency potential

Question 8

Prochlorperazine/Compazine

Answer 8

neuroleptic for emesis with migraine
primarily works as a H1 receptor antagonist
Side:
lowers seizure threshold
urinary retention, drowsiness, dry mouth, constipation

Question 9

Non-pharmacologic treatments for headache

Answer 9

riboflavin- 400 mg/ day
mg- 600-2000 mg/day
biofeedback
acupuncture