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Pharmacology > Migraines > Flashcards

Migraines Flashcards

1
Q

What are the two 5-HT agonists that can be used to treat migraines?
What receptors do they bind to?

A

1) Sumatriptan
2) Zolmitriptan

1B/1D agonists

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2
Q

Lasmiditan, a specific serotonin 5-HT agonist used for migraine is a ___ agonist

A

1F

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3
Q

What drug is an ergot alkaloid (non-specific 5-HT agonist)?

A

Dihydoergotamine

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4
Q

What are the three dopamine antagonists (aka antiemetics)?

A

1) Metoclopramide
2) Prochlorperazine
3) Chloropromazine

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5
Q

What are the five classes of drugs used as prophylactic drug therapy for migraines?

A

1) Beta blockers
2) Anti-depressants
3) Anti-convulsants
4) Calcitonin gene-related peptide ligand/receptor antagonist
5) Botox

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6
Q

True or False: There is increased GI motility that occurs during a migraine.

A

False - there is decreased GI motility that occurs during a migraine (caffeine helps to increase motility!)

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7
Q

A common migraine is a migraine without an ____ while a classic migraine is a migraine with an ____

A

aura

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8
Q

What is a common aura?

A

Fortification spectrum (visual disturbance)

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9
Q

Phases of a migraine?

A

1) Prodrome
2) Aura
3) Headache
4) Postdrome

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10
Q

During what phase of a migraine is there a progression from a dull ache to intense pulsations?

A

Headache

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11
Q

According to the Vascular Theory, why do aura arise?

A

Vasoconstriction of blood vessels prior to vasodilation

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12
Q

What causes the pain of a migraine?

A

dilation of intracranial blood vessels which activates trigeminal ganglion and registers as pain to CNS

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13
Q

True or False: IV injection of 5-HT can aport a spontaneous or drug-induced migraine

A

True

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14
Q

If you have three or more migraines per week, what type of therapy is required?

A

Prophylactic Migraine Therapy

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15
Q

What is the last resort migraine drug?

A

Butorphanol nasal spray

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16
Q

First line migraine drug?

A

-tryptans

17
Q

If one goes to the ER for a migraine, what med combo will they be given?

A

IV NSAID + metoclopramide (nausea)

18
Q

If IV NSAID + metoclopramide do not work at the ER, what can be tried?

A

dihydroergotamine + metoclopramide (nausea)

19
Q

If dihydroergotamine + metoclopramide (nausea) does not work at the ER, what’s tried?

A

Dexamethasone + metoclopramide (nausea)

20
Q

Combination analgesics, opiates, ergotamine, and triptans are associated with ___________

A

rebound headaches

21
Q

How can you avoid the problem of rebound headaches?

A

Abortive therapy should be used ~2 x a week

22
Q

____ is the only medication useful for treating medication overuse headaches?

A

Botox

23
Q

What types of abortive drug therapy is thought to work by blocking prostaglandin synthesis and preventing inflammation of the trigeminovascular system

A

NSAID’s

24
Q

What drug can treat the photophobia and phonophobia associated with migraines?

A

Acetaminophen (Tylenol)

25
Q

What three components is found in Prodrin?

A

Caffeine, acetaminophen, and isometheptene (vasoconstrictor)

26
Q

What is the benefit of adding caffeine to ergot alkaloid containing products?

A

Improves intestinal absorption/potentiate vasoconstriction

27
Q

Ergot alkaloids are very good _________

A

vasoconstrictors

28
Q

_____ is a dirty drug that interacts with serotonin, dopamine, and adrenergic receptors (note: can act as serotonin, adrenergic, or dopamine agonist)

A

Ergotamine

29
Q

How do ergot alkaloids, such as ergotamine, act?

A

Activate 5-HT 1B receptors, causing vasoconstriction

Activate 5-HT 1D (inhibit production of calcitonin related gene product, NKA, and substance P - all of which are pro-inflammatory cytokines)

30
Q

Can ergot alkaloids be used during pregnancy?

A

No (schedule X)

31
Q

Why can people get nausea with ergot alkaloid use?

A

Activates dopamine receptors in chemoreceptor trigger zone

32
Q

Why is dihydroergotamine used over ergotamine?

A

Causes less vasospasm

33
Q

What class of drugs is metabolized by MAO-A

A

Triptans

34
Q

Contraindications for triptans?

A

People taking MAO inhibitors

35
Q

Sumatriptan is an agonist at _____ serotonin receptors

A

type 1
(more specific than ergot alkaloids)

36
Q

What three drugs act on both 5-HT1B and 5-HT1D?

A

Sumatriptin, Ergot Alkaloids, and Zolmitriptin

37
Q

True or False:
The calcitonin gene-related product can directly cause vasodilation. Therefore, by inhibiting it, you prevent vasodilation

A

True

Pharmacology (53 decks)

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