Migraine Flashcards
List common migraine triggers
Hormonal changes in women
Foods
Stress
Sensory stimuli
Changes in wake-sleep pattern
Changes in the environment
What’s used for acute tx?
Triptans
NSAIDs or Excedrin Migraine
List triptans used in migraine
Naratriptan (Amerge)
Almotriptan (Axert)
Frovatriptan (Frova)
Sumatriptan (Imitrex, Alsuma)
Eletriptan (Relpax)
Rizatriptan (Maxalt, Maxalt-MLT)
Zolmitriptan (Zomig, Zomig-ZMT disint tabs)
Brand name of Sumatriptan? (Needleless sumatriptan injection)
Imitrex
Alsuma
Brand name of Sumatriptan? (SC injection)
Imitrex STATdose SC dose
Brand name of Sumatriptan? (Nasal spray)
Imitrex nasal spray
Brand name of Rizatriptan?
Maxalt
Maxalt-MLT
Brand name of Eletriptan?
Relpax
Ses of Triptans?
Triptan sensations, includes pressure in the chest or heaviness or pressure in the neck region and usually dissipate after admin
Which triptans has a nasal and SC inj formulation?
Sumatriptan
Long-acting (but slower onset) triptans?
Frovatriptan (Frova)
Shorter half-life (duration) but quick onset triptans?
Almotriptan (Axert)
Eletriptan (Replax)
Rizatriptan (Maxalt)
Sumatriptan (Imitrex, Alsuma)
Zolmitriptan
Which triptans are CI with MAO-I use?
Imitrex (Sumatriptan)
Maxalt (Rizatriptan)
Zomig (Zolmitriptan)
When should migraine prophylaxis be considered?
Migraine tx > 2 x a wk
Or
Migraine decreases quality of life
What’s 1st line agents for migraine prophylaxis?
Beta-blockers e.g.
Propranolol (Inderal)
Timolol (Blocadren)
Metoprolol (Lopressor, Toprol XL)
Valproate
Topiramate (Topamax)
What’s 2nd line agents for migraine prophylaxis?
Other beta-blockers
ACE-I
Antidepressant
Natural pdts
OCPs (for premenstrual migraine)
Botulinum toxin type A (chronic migraine only…last >= 15 days/month)
Ses of valproate/Divalproex?
Liver toxicity
Pancreatitis
Weight gain
Teratogenicity
Thrombocytopenia
SEs of Topiramte?
Weight loss
Whens Botulinum toxin type A used in migraine?
For chronic migraine only…last >= 15 days/month
Do u prime Zomig and Imitrex spray before use?
NO!!!!!!!!
Where do u admin Imitrex-STAT dose?
SC, upper outside arm
Which med is approved to treat pre-menstrual migraine + aura in women?
Nor-QD
Nora-Be
Camila
What does Fiorinal contain? Class in CS?
Aspirin + Butalbital + Caffeine
C-III
How often do u repeat the dose of Sumatriptan? PO, Nasal spray, SC injection
PO & Nasal spray - can repeat after 2 hrs
SC - after 1 hr
What’s Triptans?
5HT1 Serotonin-receptor agonists that cause vasodilation of cranial blood vessels
