Migraine

Question 1

Eletriptan (Relpax)
Naratriptan (Naramig)
Rizatriptan (Maxalt)
Sumatriptan (Imigran)
Zolmitriptan (Zomig)

Answer 1

A) Triptans OR 5HT-1 agonists

B)
1. Acute relief of Migraine

C)
#REPEAT dose >2 hrs (max /day
Zolmitriptan: 2.5-5 mg (max 10 mg)
Rizatriptan: 10 mg (max 30 mg)
Eletriptian: 40-80 mg (max 160 mg)
Sumatriptan ORAL: 50-100 mg (max 300 mg) 
Sumatriptan NOSTRIL (1): 10-20 mg (max 40 mg)
#REPEAT dose >4hrs:
Naratriptan: 2.5 mg (max 5 mg)

D)

1. Improvement of Migraine
2. Dependency (result in recurrent and/or rebound headaches with withdrawal symptoms
3. RENAL (Eletriptan, Naratriptan, Rizatriptan)
4. HEPATIC (Sumatriptan, Zolmitriptan)

E)
Labels: 12
#Should relieve headache within 30-60mins
#Most effective if taken when the headache is BEGINNING
#If no improvement with the 1st dose, DO NOT REPEAT
**DR - symptoms increase in FREQUENCY or SEVERITY
S/E
*SENSATIONS of tingling, heat, pain or heaviness/tightness in the body
*other (FLUSHING, dizziness and drowsiness, WEAKNESS)

Question 2

Pizotifen (Sandomigran)

Answer 2

A) 5HT-2 antagonist

B)
1. Prevention of recurrent Migraine and Cluster headache

C)
0.5 mg NOCTE - 4.5 mg (in 2-3 doses)

D)
1. Dose titration (slowly to avoid drowsiness)
2. Appetite/Weight (increase)
3. Epilepsy (increase seizure)
NO renal or hepatic

E)
Labels: 1
#Used for PREVENTION - won’t stop an attack once it’s started
#Take this everyday as prescribed
#Make you feel initially DROWSY and increase effects of ALCOHOL
#APPETITE may increase - pay attention to weight
*S/E
CNS (sedation, nausea, increased appetite)
ANTICHOL (dry mouth, constipation, dizziness)