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PMCOL 200 > migraines > Flashcards

migraines Flashcards

1
Q

what drives migraines

A

cortical spreading depression

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2
Q

what entails a cortical spreading depression

A

a wave of depolarization followed by desensitization

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3
Q

what is the genetic contribution to migraines

A

familial hemiplegic migraines

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4
Q

what are the 3 known genetic mutation associated with familial hemiplegic migraines

A

P/Q type calcium channels
Na / K ATPase
Na channel subunit

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5
Q

what is the largest cranial nerve

A

trigeminal nerve

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6
Q

What are the 3 main branches of peripheral processes

A

opthalmic maxilliary and mandibular

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7
Q

what are the 3 purposes of the trigeminal nerve

A

senses pain and temperature in the head region
innervated the dura matter
controls cerebral blood vessels (trigeminovascular system)

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8
Q

how does serotonin affect migraines

A

vasoconstriction

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9
Q

what is CGRP

A

calcitonin gene-related peptide

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10
Q

describe CGRP levels in those with migraine

A

elevated

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11
Q

what is propanol

A

beta blocker, decrease blood pressure, prophylactic

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12
Q

what is gabapentin

A

anticonvulsant, blocks pain transmission, prophylactic

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13
Q

what is amitriptyline

A

antidepressant, seratonin reuptake inhibitor by blocking SERT, prophylactic

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14
Q

where does caffeine act

A

adenosine receptor antagonist

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15
Q

what ergot alkaloid

A

agonist 5HT-1b/d that inhibits neurogenic inflammation

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16
Q

what is the downfall of ergot alkaloid

A

low degree of receptor selectivity

coronary vasoconstriction

17
Q

what is the half life of ergotamines

A

2 hours

18
Q

how are ergotamines excreted

A

bile

19
Q

what is bioavailability of ergotamines

A

1%

20
Q

what is a triptan

A

selective 5-HTb/d agonist

21
Q

what are the 2 mechanisms of triptans

A

vasoconstriction

inhibition of the trigeminal nerve

22
Q

what is the bioavailability of triptan (orally and subcutaneously)

A

14% orally, 96% subcutaneously

23
Q

how is triptan excreted?

A

urine

24
Q

what are CGRP antagonists

A

treatment under development

25
Q

why was olcegepant (BIBN4096) abandoned

A

poor bioavailability abandoned at phase II

26
Q

why was MK-0974 (Telcagepant) abandoned

A

elevation of aminotransferase abandoned at phase III

27
Q

what is rimegepant (nurtek)

A

effective miigraine treatment

PMCOL 200 (12 decks)

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