Pharmacologic Treatment of Headaches Flashcards
Which abortive treatments for migraine should be avoided in someone with ischemic vascular disease?
Triptans
Ergots
NSAIDs are avoided in those with _________. Why?
acute gastritis; NSAIDs (most) inhibit COX-1, which secretes protective mucus in the stomach
Ergots are ____________ treatments.
abortive
The vascular events in migraines appear to have two phases: ________________.
first vasoconstriction then vasodilation
Drug delivery can be impacted by the tendency to have _____________ with migraines.
nausea, vomiting, or GI dysmotility
Do not concurrently use ergots and triptans. Why?
Because their vasoconstrictive effects can be additive
What is the mechanism of ergots?
5HT-1b/1d agonist
When should you initiate prophylactic treatment for migraines?
When the migraines are frequent (more than four per month), disabling, or long-lasting
Which should you use first, triptans or ergots?
Triptans. Ergots have greater toxicity.
How long do prophylactic treatments take to become effective?
4-6 weeks