Migraine Ongoing Txt Flashcards
What types of medications are used for ongoing migraine treatment?
NSAIDs or acetaminophen +/- metoclopramide
ergotamines
sumatriptan
telcagepant
COX inhibitor +/- antiemetic
alpha1 adrenergic receptor agonist
selective 5-HT1B/1D receptor agonist
CGRP antagonist
What class of drug are ergotamines?
alpha1 adrenergic receptor agonist
What is the mechanism of action of ergotamines in migraine treatment?
Alpha1 adrenergic receptor agonist that decreases vasodilation of the meningeal vessels
This helps mitigate migraine symptoms.
What type of receptor does sumatriptan selectively agonize?
selective 5-HT1B/1D receptor
agonist
This action elevates serotonin (5-HT) levels in the brain.
What is telcagepant’s role in migraine treatment?
CGRP antagonist
It targets calcitonin gene-related peptide, which is involved in migraine pathology.
List some common migraine triggers.
- Menstrual cycle
- Visual/auditory/olfactory sensations
- Stress/fatigue
- Alcohol
- Hypertension/atherosclerosis
- Genetic predisposition
These triggers can initiate a migraine attack.
What is cortical spreading depression (CSP)?
Wave of neuronal excitation in the cortical grey matter associated with the aura phase of headache
Serotonin (5-HT) can inhibit this process.
What is activated in the trigeminovascular complex during a migraine?
Trigeminal nociceptors that innervate meninges
This activation contributes to the pain phase of migraine.
What neuropeptide is associated with superficial vasodilation during migraines?
Calcitonin gene-related protein (CGRP)
It can worsen the migraine symptoms by causing vasodilation.
What symptom is commonly associated with the throbbing pain of migraines?
Throbbing with every heartbeat
This occurs due to the pressure of ejected blood into the brain.
Describe the migraine pathway.
trigger-> CSD/P -> activation trigeminovascular complex that innervate meninges –> vasodilation
“CSP” can refer to either Cortical Spreading Depression (CSD), a wave of neuronal activity followed by inactivity, or Cavum Septum Pellucidum (CSP), a normal anatomical variant that can, in rare cases, cause headaches.
