Migraine Pharmacology

Question 1

Ergots are ______ Sereotonin Receptor Agonists

Answer 1

Non-selective

Question 2

Valproate, divalproex, and topiramate are all _____ drugs which often enhance GABA-inhibition

Answer 2

Anti- Seizure

Question 3

Is Valproate safe for pregnant women?

Answer 3

No

Question 4

Most serious side-effet of valporate therapy is _____, but the risk appears to be low in people with migraines

Answer 4

Hepatotoxicity

Question 5

Since the Ergots are so powerful, what is the most common side-effect and 3 contraindications, aside from being pregnant?

Answer 5

• Nausea and Vomiting
  1. Kidney
  2. Liver
  3. Heart/HTN

Question 6

Contraindication for NSAIDS?

Answer 6

Tummy probs

Question 7

Ergots and Triptans both work by promoting serotonin’s function, which will Vaso-______.

Answer 7

Constrict

Question 8

Treatment Algorithm for Acute migraine headaches: Diagnose–Educate–If mild and predictable then consider _______ at first, and then _______ if inadequate response.

Answer 8

• NSAIDS

- Triptans

Question 9

If you have HTN and headaches, since the Ergots & Triptans are ruled out, what pharmaco class would be recommended?

Answer 9

B-Adrenergic Antagonists

-olols

Question 10

Main side effects of B-Adrenergic Antagonists?

Answer 10

“Slow and sleepies”

- drowsiness, fatigue, sleep disturbance, bradycardia, hypotension

Question 11

Among the triptans, state two facts about Frova and Nara

Answer 11

1. Longest half-life

2. Less efficacious (y-axis)

Question 12

Amitriptyline and Venlafaxine are both ______ ______ drugs, with ______ side effects

Answer 12

• Tricyclic Anti-depressant

- Anticholinergic

Question 13

Triptans are ______ Serotonin receptor agonists

Answer 13

Selective

1B and 1D

Question 14

Aside from patients taking SSRIs, name Two contraindications for Triptans

Answer 14

1. HTN

2. Heart probs

Question 15

For the treatment algorithm in migraines, when you have severe symptoms, the _______ should be considered

Answer 15

Ergots