Migraine 🤕(Shelby🐈) Flashcards
What does Botox have to do with migraines
it can be used as migraine prophylaxis 💉
… does this mean my insurance will cover it???
Which is specific for 5HT1D, triptans or ergots
triptans!!!!
ergots 5HT only
Which migraine medication vasoconstricts the arteries of the brain (specifically)
Triptans
The treatment of acute migraines utilizes medications that do what
VASOCONSTRICT 🐍🐍🐍🐍🐍🐍🐍🐍🐍🐍🐍
DO NOT F THIS UP
What was the crazy story he told about in the lecture with st anthony and everyone’s limbs falling off and what did it have to do with migraine medicine
ergots
they make your limbs falls off if taken chronically due to the VASOCONSTRICTION 🐍☠️
Which seizure medications can be used for prophylactic treatment of migraines 🤯
Valproic Acid (Depakene) Topiramate (Topomax)
a 35 year old female presents with acute abdominal pain, bloody diarrhea, cramping, dizziness, and lightheadedness. You have a whole list of GI things on your ddx, you think maybe ectopic pregnancy because you are thinking outside of the box, but you learned in PA school to always have “medication reaction” on your ddx. You ask her if she has started any new medications recently and she tells you “YES omg HOW did you KNOW???” and you are very smart so you ask her, “do you happen to get migraines?” and she’s like “holy shit are you a PA or a fkn psychic???”
What drug do you know she is on
Triptans! 💩💩
maybe ergots but probably not because NOBODY USES THOSE
Which analgesics are used to treat the pain in migraine?
Which are specifically NOT used to treat the pain in migraine?
Aspirin, Acetaminophen, Naproxen
Not opioids
Which antidepressants can be used for prophylactic treatment of migraines
Amitriptyline (Elavil, Endep)
Fluoxetine (Prozac)
which migraine medication is similar to Ergotamine but may have less side effects
Dihydroegotamine (Migranal)
What are the two IgG2 monoclonal antibody binds to calcitonin gene-related peptide (CGRP) that can be used for prophylactic treatment of migraines
Erenumab (Aimovig)
Galcanezumab (Emhgality)
Which produces MORE vasoconstriction, triptans or ergots?
ergots produce more vasoconstriction than triptans 🐍🐍🐍🐍🐍🐍🐍
less specific 5HT receptor AND is ALSO an alpha 1 agonist which produces even MORE vasoconstriction
Which calcium channel blocker can be used for prophylactic treatment of migraines
Verapamil (Calan, Isoptin)
What are the contraindications for triptans
if you have anything where vasoconstriction would be a problem 🚫🐍
Breast-feeding, cardiac disease, cerebrovascular disease, coronary artery disease, diabetes, hypertension, intravenous administration, peripheral vascular disease, pregnancy, renal impairment, seizures, smoker
Ergot MOA
5HT receptor agonists and alpha 1 agonists
not specific for 5HT1D like triptans
How many prophylactic agents for migraines can you name?
Beta-Blockers Calcium Channel Blockers Antidepressants Clonidine (Catapress) Valproic Acid (Depakene) Topiramate (Topomax) Botulinum Toxin Angiotensin II Receptor Blockers (ARBs) Erenumab (Aimovig) Galcanezumab (Emhgality)
What are the side effects of Triptans
General vasoconstriction which produces detrimental effects systemically***** 🐍🐍🐍
Cardiovascular issues, arrhythmias, stroke, seizures, cerebrovascular issues, peripheral vascular ischemia, bowel ischemia, abdominal pain, bloody diarrhea, cramping, dizziness, lightheadedness, weakness, myalgia, muscle cramps
A 55 year old female comes in to your office and she tells you that she can’t feel her feet anymore. You immediately want to call the toe bro, but you think you can handle it. You put diabetes at the top of your list because why wouldn’t you. You do a fingerstick glucose and it’s normal. You get a whole diabetes work-up and it’s all normal. You take a look at her feet and they are NECROSED. 👣☠️ The smell of dead feet wafts over you and you realize this lady might have a history of migraines. 👃🏽🤢
How do you know this?
She has chronic ergotism
She took ergots for like 40 years for her migraines
vasoconstriction to the limbs 🐍🐍🐍
dead fucking feet ☠️👣
You have a 29 year old female come into your office complaining of anxiety, depression, and migraines.
How do you kill all 3 birds with one stone 🐦🐦🐦
Fluoxetine (Prozac)
used for migraine PROPHYLAXIS
If someone is on an ergot for migraines for like 30 years, what is a possible side effect?
Chronic ergotism: vasoconstriction leading to GANGRENE ☠️
Triptan MOA
5-HT 1D receptor agonist on small peripheral nerves
Vasoconstriction 🐍 of the arteries in the brain 🧠(specific)
Which beta blocker can be used for prophylactic treatment of migraines
Propranolol (Inderal)
Which medications that are traditionally used in heart problems can be used as prophylactic agents for migraines ❤️❤️❤️❤️
❤️Beta-Blockers
❤️Calcium Channel Blockers
❤️Clonidine (Catapress)
❤️Angiotensin II Receptor Blockers (ARBs)
