migraine drugs Flashcards
potential causes of migraines
trigeminal system
genetic predispositions
how is the trigeminal system activated
Cortical spreading depression activates the trigeminal vascular system
where does the pain come from
nerves and the meninges release CGRP
vasodilation stretches sensory receptors in the vessel wall
how does the pain stimuli get sensed
trigeminal nerve sends sensory input to the VPM and to the primary somatosensory cortex
mutations associated with migraines
mutations that cause dysregulation in Na, Ca, and k pumps
drug to be used during the prodrome or aura
ergotamine
drug to be used during the aura or headache
sumatriptan
naproxen
traditional prophylactic treatment
propranolol
amitriptyline
topiramate
administration of ergotomine
sublingual
MOA of ergotamine
blocks alpha adrenergic receptors to cause vasodilation
inhibits 5-HT activity by activating 5-HT1D receptors
mechanism of 5-HT1d receptor
inhibits post-synaptic cell signaling
mechanism of 5-HT1B receptor
inhibitory autoreceptor
how does blocking 5-ht signaling help with headaches
it causes vasoconstriction and inhibition of pro-inflammatory neuropeptide release
what causes the aura
cortical spreading depression
sumatriptan MOA
bind 5-HT1B/1D to inactivate 5-HT