Migrane Drugs

Question 1

Pathysiology of migraine drugs explain

Answer 1

*irritation of trigeminal nerves in the meninges
*molecules released are substance p,vasoactive peptide and CGRP
These neurotransmitters bind with mast cells and cause vasodilation which cause migraine
*the neurotransmitters can also act on the blood vessels and lead to Nitrous oxide which can also cause vasodilation
*the neurotransmitters can act directly on the trigeminal nerve directly and cause pain sensation from the head and face

Question 2

Migraine presents with what conditions

Answer 2

Aura:serotonin levels are high ,5HT1
Migraines with out aura (less serotonin 5HT1

Question 3

List group of drugs for acute therapy of migraine .

Answer 3

*NSAids
*Triptans
*Ergots
*Steriods

Question 4

List drugs for the prophylactic therapy

Answer 4

*propranolol
*Anticonvulants
(ToPiramate)
Valproate
*CGRP antagonists
*Botox.A injections to block pain sensations

Question 5

Names and Mechanism of action of triptans

Answer 5

Sumatriptan
Zolmitriptan oral
Mechanism:act on 5HT1 B and D which inhibits the release of vasoactive peptide,substance P and cGRP
Triptans also act on peripheral blood vessels and lead to vasoconstriction

Question 6

Names and mechanism of ERgots

Answer 6

*Dehydroergotamine
Act on all 5HT receptors
Bind to 5HT
Can also cause vasoconstriction in peripheral blood vessels
*Binds to alpha 1And cause vasoconstriction

Question 7

NSAIDs drugs used for migraine

Answer 7

*Ibuprofen
*Naproxen
*Ketoralal
Mechanism of action (block prostaglandin

Question 8

Steroid drug for migraine

Answer 8

Dexamethasone

Question 9

Prophylactic therapy Beta blockers

Answer 9

*propranolol
*metoprolol
Bind to B2 receptors in peripheral blood and inhibit Vasodilation causing vasoconstriction

Question 10

CGRp antagonists drug

Answer 10

Erenumab

Question 11

Botulism toxin A

Answer 11

Inhibits the pain signals by injecting into the trigeminal nerve in the head

Question 12

Adverse effects of triptans

Answer 12

*vasoconstriction of coronary - angina,prizemetal angina and can induce myocardial infarction
*hypertension due to vasoconstriction
*peripheral vascular disease
*cold extremities

Question 13

Contraindications of triptans

Answer 13

*pregnancy

Question 14

Adverse of ergots

Answer 14

Vasoconstriction effect
*angina
*blood pressure
*peripheral artery disease
*Acute myocardial infarction
* nausea and vomiting
*hepatotoxicity

Question 15

Contraindications of egort

Answer 15

Pregnancy

Question 16

Combination of triptans and ergots or SSRI or TCA will lead to what syndrome

Answer 16

Serotonin syndrome
*agitations
*Delirium
*increased BP and heart rate
*increases body temperature
*sweating
*hypertonia and nausea and vomiting
*Increased Git motility (diarrhea)

Question 17

Ergot toxicity

Answer 17

Seizures
Gangrenous necrosis of digits

Question 18

Treatment of ergot toxicity

Answer 18

*Anticoagulants
*low molecular weight dextran
*vasodiators

Question 19

Adverse effects of cGRP antagonists

Answer 19

*Pain in site of injection
*Anaphylaxis shock( because it is a monoclonal antibody that can react with the immune system)