Pharm: Migraine Meds Flashcards
Indomethacin
Used for moderate migraine pain
MOA: increases pain threshold by decreasing prostaglandin synthesis
SE: ulcers, GI bleeding, rebound headaches
Ibuprofen
Used for moderate migraine pain
MOA: increases pain threshold by decreasing prostaglandin synthesis
SE: ulcers, GI bleeding, rebound headaches
Aspirin
Used for moderate migraine pain
MOA: increases pain threshold by decreasing prostaglandin synthesis
SE: ulcers, GI bleeding, rebound headaches
Naproxen
Used for moderate migraine pain
MOA: increases pain threshold by decreasing prostaglandin synthesis
SE: ulcers, GI bleeding, rebound headaches
Sumatriptan
Used for acute migraine headaches
MOA: 5HT1 agonist
- stimulate vasoconstriction of basilar artery and dura mater vessels
- block proinflammatory NTs like CGRP and substance P around the trigeminal nerve
SE: serotonin syndrome
Zolmitriptan
Used for acute migraine headaches
MOA: 5HT1 agonist
- stimulate vasoconstriction of basilar artery and dura mater vessels
- block proinflammatory NTs like CGRP and substance P around the trigeminal nerve
SE: serotonin syndrome
Naratriptan
Used for acute migraine headaches
MOA: 5HT1 agonist
- stimulate vasoconstriction of basilar artery and dura mater vessels
- block proinflammatory NTs like CGRP and substance P around the trigeminal nerve
SE: serotonin syndrome
Codeine
Opioid
Used for mild to moderate pain
Used for migraines in patients that cannot tolerate triptans
MOA: metabolized to morphine for a weaker effect. Agonist at mu, kappa, and delta receptors
SE: addiction
Morphine
Opioid
Used for severe pain or severe migraine headaches in patients that cannot tolerate triptans
MOA: agonist at mu, kappa, and delta receptors
SE: addiction
Dexamethasone
Corticosteroid
Used in combination with other drugs as a pain reliever.
MOA: inhibition of phospholipase A for anti-inflammatory effects
SE: steroid toxicity
Caffeine
Xanthine Alkaloid
Used for headaches, usually in combination with acetaminophen, aspirin for moderate migraine pain.
MOA: inhibits phosphodiesterase leading to increased cAMP levels
SE: insomnia, agitation, restlessness
Acetaminophen
Used when aspirin is contraindicated.
Combined with isometheptene and dichloralphenazone for moderate headaches
Combined with butalbital for infrequent headaches with moderate to severe intensity (GABAmimetic)
!!!!!this and opioids are only viable option during pregnancy!!!
MOA: COX inhibitor without the anti-inflammatory effects
SE: toxic to liver in high continued doses
Propranolol
Migraine Prophylaxis that inhibits sodium channels within membranes of neurons to prevent firing of pain signals
MOA: non-selective beta blocker
Verapamil
Migraine Prophylaxis, relieves symptoms of aura
MOA: calcium channel blocker
Lisinopril
Reduces duration and severity of migraines by keeping BP down
MOA: ACE inhibitor
Amitriptyline
Migraine prophylaxis
MOA: 5HT and NE reuptake inhibitor
SE: AV bundle branch block, anorexia, blurred vision, dry mouth, constipation, sedation, weight gain, may precipitate MANIA in BIPOLAR disorders
Nortriptyline
Migraine prophylaxis
MOA: 5HT and NE reuptake inhibitor
SE: AV bundle branch block, anorexia, blurred vision, dry mouth, constipation, sedation, weight gain, may precipitate MANIA in BIPOLAR disorders
Pizotifen
Prophylaxis for recurrent migraines when beta-blockers are contraindicated.
MOA: 5HT2 antagonist and moderate histamine and cholinergic antagonist
SE: weight gain, drowsiness
Topiramate
Anti-seizure meds and migraine prophylaxis
MOA: voltage gated sodium channel inhibitor, AMPA/kainate inhibitor, calcium channel inhibitor
SE: increased IOP, poor concentration, weight loss, induces P450 enzymes in liver
Valproate (ionized form of valproic acid)
Used for seizures and migraine prophylaxis
MOA: enhances GABA transmission, inhibits sodium channels and T type calcium channels
SE: weight gain, fetal abnormality, hair loss, tremor
Gabapentin
Used for partial seizures and neuroleptic pain
MOA: analog of GABA, inhibits voltage calcium channels
SE: dizziness, sedation, peripheral edema
Botulinum Toxin
Used for chronic migraines in adults
MOA: inhibits SNAP-25, a snare protein required for vesicles containing neurotransmitters to bind and release contents into the synapse
SE: reversible paralysis
Chlorpromazine
Used as an antiemetic, for schizophrenia, Tourette syndrome, huntington chorea, dementia
MOA: anticholinergic, anti-dopaminergic, anti adrenergic, anti histaminergic
SE: phototoxicity, blurred vision, constipation
Prochlorperazine
Used as an antiemetic, for schizophrenia, Tourette syndrome, huntington chorea, dementia
MOA: anticholinergic, anti-dopaminergic, anti adrenergic, anti histaminergic
SE: blurred vision, constipation, amplifies quinidine mediated cardiotoxicity, weakly diuretic
Metoclopramide
Used for migraines, gastric stasis, stimulate lactation
MOA: D2 and 5HT3 antagonist, agonist at 5HT4
SE: galactorrhea, extrapyramidal effects, tardive dyskinesia
Not to be used in patients with pheochromocytoma or Parkinson disease
