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Neuro/psych exam 2 > migraine drugs > Flashcards

migraine drugs Flashcards

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1
Q

potential causes of migraines

A

trigeminal system
genetic predispositions

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2
Q

how is the trigeminal system activated

A

Cortical spreading depression activates the trigeminal vascular system

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3
Q

where does the pain come from

A

nerves and the meninges release CGRP
vasodilation stretches sensory receptors in the vessel wall

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4
Q

how does the pain stimuli get sensed

A

trigeminal nerve sends sensory input to the VPM and to the primary somatosensory cortex

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5
Q

mutations associated with migraines

A

mutations that cause dysregulation in Na, Ca, and k pumps

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6
Q

drug to be used during the prodrome or aura

A

ergotamine

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7
Q

drug to be used during the aura or headache

A

sumatriptan
naproxen

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8
Q

traditional prophylactic treatment

A

propranolol
amitriptyline
topiramate

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9
Q

administration of ergotomine

A

sublingual

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10
Q

MOA of ergotamine

A

blocks alpha adrenergic receptors to cause vasodilation
inhibits 5-HT activity by activating 5-HT1D receptors

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11
Q

mechanism of 5-HT1d receptor

A

inhibits post-synaptic cell signaling

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12
Q

mechanism of 5-HT1B receptor

A

inhibitory autoreceptor

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13
Q

how does blocking 5-ht signaling help with headaches

A

it causes vasoconstriction and inhibition of pro-inflammatory neuropeptide release

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14
Q

what causes the aura

A

cortical spreading depression

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15
Q

sumatriptan MOA

A

bind 5-HT1B/1D to inactivate 5-HT

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16
Q

onset time of sumatriptan

A

fast- 1.5 hours

17
Q

adverse effects of sumatriptan

A

altered sensations

18
Q

contraindications of sumatriptan

A

do not use if patient has taken ergotamine in 24 hours, do not use in patients with angina and CAD

19
Q

naproxen MOA

A

abortive drug for hemiplegic migraines
COX1 & 2 inhibitor

20
Q

when should prophylaxis be used

A

when abortive treatment is used 2-3 times per week

21
Q

propranolol MOA

A

blocks beta adrenergic receptors to prevent of relay to primary somatosensory cortex

22
Q

when can propranolol be used

A

in patients with a single headache type

23
Q

main side effect of propranolol

A

fatigue

24
Q

propranolol contraindicated in those with ____

A

cardiac issues

25
Q

when is amitriptyline used

A

mixed migraine and tension headaches

26
Q

MOA of amitriptyline

A

blocks reuptake of 5-HT and NE… unclear why it works

27
Q

side effect of amitriptyline

A

somnolence

28
Q

erenumab MOA

A

CGRP antibody

29
Q

how is erenumab used

A

prophylactic autoinjector

Neuro/psych exam 2 (11 decks)

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