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PODA-Migraine > PODA-Migraine > Flashcards

PODA-Migraine Flashcards

1
Q

Activation of ______ receptors in cranial blood vessels causes _________.

A

5-HT1B; Vasoconstriction

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2
Q

Activation of prejunctional 5HT1D receptors on trigeminal fibers inhibits what?

A

CGRP release

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3
Q

Which serotonin receptor is located on both blood vessels and within the trigeminal ganglion, and trigeminal nucleus caudalis.

A

5HT1F

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4
Q

CGRP is a potent vasodilatory peptide, causes _________________ and modulates __________.

A

Inflammation and modulates pain signaling

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5
Q

TorF: Elevated CGRP levels are shown during migraine attacks and in pain free intervals?

A

True

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6
Q

TorF: CRGP also causes mast cell degranulation which activates nociceptors

A

True

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7
Q

What leads to photophobia in migraines?

A

CGRP enhancing synaptic excitability

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8
Q

What are the two ergot alkaloids that are used to treat migraines?

A

Ergotamine and dihydroergotamine

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9
Q

What classes of medications are used in the TREATMENT of migraines?

A

Ergot alkaloids, triptans, ditans, gepants

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10
Q

What classes of medications are used in the prophylaxis of migraines?

A
  • Anti-CGRP monoclonal antibodies
  • Onabotulinum Toxin A (Botox)
  • b-adrenoceptor blockers : propranolol
  • Tricyclic antidepressants: Elavil, Effexor
  • Anticonvulsants: valproic acid, topiramate
  • Calcium channel blockers: verapamil
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11
Q

TorF: Some 5HT receptors have analgesic properties?

A

True

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12
Q

Which class of medications act on serotonin receptors?

A

Ergot alkaloids, triptans, ditans

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13
Q

Ergot alkaloids act as agonists or antagonists at which receptors?

A

5HT1A, 5HT1D, a-, and dopamine receptors

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14
Q

This medication acts on 5HT1B/1D receptors on intracranial arteries to cause vasoconstriction in migraines…

A

Ergotamine

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15
Q

Ergotamine has a drug intx with what other drugs? and why?

A

POTENTIATED BY CPY3A4 INHIBITORS

  • Macrolides(Infections)
  • Fluoxetine(SSRI)
  • Grapefruit juice
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16
Q

The triptans used for treatment of migraine headaches include:

A

Sumatriptan, naratriptan, rizatriptan, eletriptan, almotriptan, frovatriptan, zolmitriptan

17
Q

MOA of sumatriptan:

A

Activation of 5HT1B/1D receptors

18
Q

Sumatriptan is available in these dosage forms:

A

PO, SUBQ, inhalation

19
Q

Drug intx w.sumatriptan:

A

Concomitant ergotamines, other 5HT1 agonist, MAOIs

20
Q

MOA of Lasmiditan:

A

Activation of 5HT1F receptors in the trigeminal nucleus caudalis blocks the release of CGRP and glutamate which prevents the development of central sensitization

21
Q

Activation of 5HT1F receptors in the thalamus can block the secondary central sensitization of this area associated with the progression of migraine describes which drug?

A

Lasmiditan

22
Q

TorF: Lasmiditan can also decrease pain modulation and alleviate migraines

A

true

23
Q

drug intx of Lasmiditan?

A

SSRIs, SNRIs, TCAs

24
Q

Oral CGRP receptor antagonists includes:

A

Gepants: ubrogepant, rimegepant

25
Q

What are the drug intx of the gepants?

A

Moderate CYP3A4 inhibitors: cyclosporine, ciprofloxacin

Antagonized by CYP3A4 inducers: phenytoin, barbiturates

26
Q

Anti-CGRP monoclonal antibodies:

A

THE MABS:

  • erenumab (prototype)
  • fremanezumab
  • galcanezumab
27
Q

MOA of ACGRPMA:

A

block CGRP receptors

OR

bind the CGRP ligand and inhibits its activity at receptor sites

28
Q

TorF: ACGRPMA can cross the BBB?

A

False, bc they are large molecules

29
Q

TorF: severe constipation is a side effect of ACGRPMA

A

True, in addition to cramps and muscle spams

30
Q

An intramuscular medication used in the prophylaxis of migraines, _____________, acts by inhibition of the release of CGRP from PVS

A

Onabotulinum toxin A

PODA-Migraine (1 decks)

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