Migraines Flashcards
1
Q
Serotonin 1B/1D Receptor Agonist
- First-line drug for terminating migraine attack
- Selective activation of 5-HT1B and 5-HT1D receptors (5-HT1B/1D receptors)
- Binding to 5-HT1B/1D receptors on sensory nerves of the trigeminal vascular system suppresses the release of CGRP, a compound that promotes release of inflammatory neuropeptides
- Adverse effects: chest symptoms, coronary vasospasm, teratogenesis
A
Sumatriptan
2
Q
- Can alter transmission at serotonergic, dopaminergic, and α-adrenergic junctions
- Can block inflammation associated with the trigeminal vascular system, perhaps by suppressing release of CGRP
- Side effects: weakness in the legs, myalgia, numbness and tingling in the fingers and toes, angina-like pain, and tachycardia or bradycardia
- Overdose: can cause ischemia secondary to constriction of peripheral arteries and arterioles: the extremities become cold, pale, and numb; muscle pain develops; and gangrene may eventually result
- Contraindicated for patients with hepatic or renal impairment, sepsis (gangrene has resulted), CAD, peripheral vascular disease, and uncontrolled hypertension, and for those taking potent inhibitors of CYP3A4
A
Ergotamine
3
Q
Ergot alkaloid
- Given by the intramuscular (IM), intravenous (IV), or subQ route
- Causes little nausea and vomiting, no physical dependence, and minimal peripheral vasoconstriction
- Diarrhea prominent
A
Dihydroergotamine
4
Q
Human immunoglobulin G2 monoclonal antibody
- Binds to, and antagonizes the function of, the CGRP receptors, and is thought to play an important role in the development of migraine headache
A
Erenumab
