migraines

Question 1

which criteria need to be met to define migraine?

Answer 1

N/V OR photophobia and phonophobia

Question 2

temporal progression of migraine

Answer 2

1. prodrome
2. aura
3. HA
4. resolution
5. postdrome

Question 3

visual disturbances occur during which phase of migraine?

Answer 3

aura phase

Question 4

non-specific pain meds used to tx acute migraines

Answer 4

ASA, acetaminophen, NSAIDS, opiates

Question 5

specific migraine drugs

Answer 5

ergotamine, dihydroergotamine, triptans

Question 6

preventive tx reduces migraine attacks by ____% in ____ of patients

Answer 6

reduces by 50% in 2/3 of patients

Question 7

what is the tx of choice for preventative tx of migraines?

Answer 7

beta blockers

Question 8

AE: Drowsiness, weight gain, tremor, hair loss, hematological and liver abnml, teratogenic - what drug?

Answer 8

anticonvulsants used for migraines - valproic acid, topiramate

Question 9

issue with using NSAIDS + acetaminophen for tx of acute migraine attacks?

Answer 9

if overused, drug can transform migraine into a more severe, chronic disorder

Question 10

which antiemetic may have some direct beneficial effects in tx of migraines?

Answer 10

metoclopramide

Question 11

MOA: Vasoconstriction due to stimulation of a-adrenergic and 5HT1D receptors (partial agonists)

Answer 11

ergot alkaloids (ergotamine + dihydroergotamine)

Question 12

why are the -triptans better than ergot derivatives

Answer 12

1. selective pharmacology

2. established efficacy + safety record

Question 13

MOA: Selective 5HT1d/1b receptor agonists (vasoconstriction); inhib activation of trigemial afferent nociceptors - which drug?

Answer 13

sumatriptan

Question 14

what typically resolves most migraines?

Answer 14

sleep