Pharmacology of Migraine Medicaiton

Question 1

What is the MOA of ergot alkaloid migraine medications?

Answer 1

Bind 5-HT1 and alpha receptors and cause major vasoconstriction

Question 2

What is the first line Triptan for migraine treatment?

Answer 2

Sumatriptan

Question 3

True/False. Patients may have different responses to different Triptans. Failure of one does not indicate failure of another.

Answer 3

True

Question 4

What is an absolute contraindication for use of ergot alkaloids?

Answer 4

Pregnancy

Question 5

What is the only Triptan that may be used for preventative treatment of migraine?

Answer 5

Frovatriptan

Question 6

These drugs may be used for acute treatment of migraines when triptans fail or are contraindicated.

Answer 6

Small-molecule CBRP receptor antagonists - Ubrogepant, Atogepant, Rimegepant

Question 7

What are the ergot alkaloid migraine medications?

Answer 7

Ergotamine, dihydroergotamine

Question 8

What class of drugs is the first line for migraine acute treatment?

Answer 8

Triptans

Question 9

Triptans are contraindicated in what patients?

Answer 9

Patients with coronary artery disease or peripheral vascular diseases

Question 10

What ADRs are associated with CBRP antagonists?

Answer 10

Drowsiness, pain at injection site, constipation

Question 11

What are the pathophysiologic changes associated with the headache phase of migraine?

Answer 11

Vasodilation and neurogenic inflammation

Question 12

True/False. CBRP antagonists should be avoided in pregnant women and patients with heart conditions

Answer 12

False - CBRP antagonists are indicated in pregnant women and patients with heart conditions that cannot take 5HT-1 agonists

Question 13

What is the most important neuropeptide involved in migraine disorders?

Answer 13

Calcitonin-Gene Related Peptide (vasodilator)

Question 14

What drugs are most commonly used for preventative migraine treatment?

Answer 14

Anticonvulsants, beta blockers

Question 15

What is the MOA of CBRP antagonists for migraine treatment?

Answer 15

Blocks pain transmission and neurogenic inflammation

Question 16

What is the use of monoclonal antibodies in migraine treatment?

Answer 16

Last-effort preventative treatment that blocks the CBRP receptor site

Question 17

Dizziness and drowsiness are associated with which anti-migraine medication?

Answer 17

Lasmiditan

Question 18

What small-molecule CBRP receptor antagonists may be used for preventative migraine treatment?

Answer 18

Atogepant, Rimegepant - longer half lives

Question 19

This class of serotonin receptors promotes vasoconstriction and prevents neuropeptide release.

Answer 19

5-HT1

Question 20

What characteristic distinguishes Lasmiditan from other 5-HT1 agonists?

Answer 20

Only blocks neuropeptide release, does not have vasoconstriction properties

Question 21

Chest-related symptoms are most associated with what migraine medication?

Answer 21

Triptans - due to vasoconstriction

Question 22

What beta blocker is most commonly used for preventative migraine treatment?

Answer 22

Propanolol