Migranie Flashcards
What are the main features of migraine
POUND Pulsatile headache One day duration Unilateral Nausea Disabling
What does acute treatment of migraine do
Help manage the pain
What does prophylaxis of migraine do
Keep headache from happening
What are the acute treatments of migraine
Triptans
Ergot alkaloids
Common analgesic drugs
How is mild to moderate migraine pain treated
NSAIDs and Butorphanol
How is severe migraine pain treated
Triptans and ergot alkaloids - mimic serotonin to mimic vasoconstriction
What are triptans
Agonists at 5-HT1B and 5HT1d receptors
List the triptans
End with triptan Sumatriptan Rizatriptan Naratriptan Zolmitriptan
When are triptans given
In moderate to severe pain or when mild symptoms don’t go away with analgesics
Mode of administration of triptans
Oral
But if the person suffers from a lot of vomiting and nausea we can give them as
Nasal spray of SUMA
When do we move on to ergot alkaloids
When triptans don’t work
List ergot alkaloids
Ergotamine and dihydroergotamine
What are ergot alkaloids
Non selective 5HT agonists
Ergot alkaloids contraindications
Pregnancy
Migraine first line prophylaxis
B-blockers - propanol and metoprolol
Which CCB is used for migraine prophylaxis
Verapamil
Which TCAs is used for migraine prophylaxis
Amitriptyline
How is Botox used in migraine prophylaxis
Blocking sensation
Ergot alkaloids and triptans side effects
Rebound headache
Leads to angina and chest discomfort in patients with CAD
What is CGRPs
Calcitonin gene related peptide - antagonist/antibodies for migraine prophylaxis
What are CGRPs used for
Migraine prophylaxis
List CGRPs and their mechanism of action
Galcanezumab, fremanezumab - target CGRP
Erenumab(target CGRP receptors)
What drugs are used for erectile dysfunction
First line - oral PDE5 inhibitors
PDE5 inhibitors mechanism of action
Increases levels of CGMP which leads to smooth muscle relaxation
List PDE5 inhibitors and their onset
Suffix FIL Avanafil - 15 to 30 mins Sildenafil - 30-60 mins Vardenafil - 30-60 mins Tadalafil - 60-120 mins (up to 36 hours)
PDE5 inhibitors contraindications
Contraindicated with organic nitrates
