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Pharmacology > Migrane pharmacology > Flashcards

Migrane pharmacology Flashcards

1
Q

Treatment for mild migrane

A

NSAIDS

Caffeine

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2
Q

Combination preps for migrane

A

butalbital + NSAID + caffeine +/- codeine

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3
Q

Concerns with combination preps

A

rebound headaches
may convert episodic migranes to chronic migranes
Dependence

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4
Q

Antiemetics for migrane

A

metoclopramide

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5
Q

Advantages of metoclopramide

A

antiemetic and enhances GI motility

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6
Q

Side effects of metoclopramide

A

RESTLESSNESS, ANXIETY, drowsiness, fatigue

D2 receptor antagonist

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7
Q

Prototype triptans

A

sumitriptan

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8
Q

MOA of triptans

A

5HT1B, 5HT1D receptor agonist, selective for cerebral vasculature

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9
Q

Advantages of triptans

A

reduces nausea and vomiting

increases GI motility

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10
Q

Metabolism of triptans

A

MAO-A

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11
Q

Side effects of triptans

A 
associated with vasoconstriction
heaviness in head
warmth, drowsiness, dizziness
chest discomfort
increase blood pressure
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12
Q

Drug interactions of triptans

A

anything that causes vasoconstriction (propranalol)

MAO-A blockers

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13
Q

Contraindications of triptans

A

ischemic heart disease
angina
MAO-A inhibitors

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14
Q

General considerations for triptans

A

30-40% recur in 24 hrs, give second dose

rebound headaches can occur

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15
Q

Prototype Ergot alkaloid

A

dihydroergotamine

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16
Q

MOA of ergots

A

5HT1B and 5HT1D receptor agonists, not as selective

17
Q

Side effects of ergots (6)

A 
nausea, vomiting
muscle weakness, numbness
angina
hypersensitivity
fibrosis
gangrene
18
Q

Drug interactions with ergots

A

potentiate Beta blockers

19
Q

Contraindications of ergots

A

pregnancy
cardiovascular disease
poor hepatic, renal function
cyp3A4 inhibitors, ischemia

20
Q

Treatment for children with migranes

A

ibuprofen, acetominophen

sumatriptan, effective, but not approved

21
Q

Opiate used for migranes

A

Stadol NS

22
Q

MOA of Stadol NS

A

kappa receptor agonist

23
Q

Therapeutic use of Stadol NS

A

use only when triptans and ergots are ineffective

may convert to chronic migrane

24
Q

Treatment for severe migranes

A

prophylactic therapy

25
Q

Herbal treatment for migranes

A

Petasites, level A

26
Q

Beta receptor antagonist for migranes

A

propranalol, level A

27
Q

antidepressants for migranes

A

TCAs, amitriptyline

level B

28
Q

Antielipeptic drugs for migranes

A

Increase GABA signalling, level A
valproic acid
topiramate

29
Q

Triptan for migrane prophylaxis

A

frovatriptan, esp for menstrual migranes, level A

30
Q

Botox for migranes

A

approved only for chronic migrane

Pharmacology (35 decks)

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