Migraine Therapy

Question 1

Sumatriptan

Answer 1

MOA: 5-HT1B/1D receptor agonist at the receptors on the trigeminal nerve and on blood vessels –> vasoconstricts and decreases neuropeptide release

Use: anti-migraine, also decreases associated N/V

SE: tingling, fatigue, chest tightness

PK: metabolized by MAO-A

CI in patients taking SSRIS or MAOIs (serotonin syndrome) and patients with CV disease; pregnancy category C

Question 2

Dihydroergotamine

Answer 2

MOA: 5-HT1D agonist at receptors on the trigeminal nerve

Use: anti-migraine

SE: N/V, ergotism with overdose (hallucinations, convulsions, gangrene), fibrosis with long term use

CI in patients taking triptans, b-blockers, DA; pregnancy category D (vascular abnormalities, cerebral impairments)