Smooth Muscle Vasoactive Drugs: Triptans & Migraine

Question 1

migraine pain is due to

Answer 1

activation of trigeminal nerve afferents in the meninges

Question 2

migraine pain due to activation of trigeminal nerve afferents in the meninges

Answer 2

trigeminal afferents release vasoactive peptides (e.g. CGRP, substance P, neurokinin A) onto meningeal vessels → vasodilation and protein extravasation

Question 3

triptans (e.g. sumatriptan) are an acute treatment for

Answer 3

1. migraines

2. cluster headaches

Question 4

triptans (e.g. sumatriptan) are

Answer 4

5-HT1b and 5-HT1d receptor agonists

Question 5

5-HT1b and 5-HT1d receptors are located on the

Answer 5

meningeal vessels

Question 6

triptans (e.g. sumatriptan) cause

Answer 6

1. vasoconstriction of cerebral and meningeal vessels

2. vasospasm

Question 7

triptans also activate 5-HT1b and 5-HT1d receptors

Answer 7

1. on the trigeminal nerve, preventing release of vasoactive peptides
2. in the brain stem, inhibiting pain pathways

Question 8

triptans are contraindicated in patients with

Answer 8

angina

Question 9

triptans are a known trigger of

Answer 9

Prinzmetal angina

Question 10

______ are an acute treatment for migraine

Answer 10

1. NSAID

2. Triptans

Question 11

_______ can be used for migraine prophylaxis

Answer 11

1. calcium channel blockers
2. beta blockers
3. valproic acid
4. Topiramate
5. TCAs (amitrtiptyline)

Question 12

Antiepileptics that can be used for migraine prophylaxis include

Answer 12

1. Valproic acid

2. Topiramate

Question 13

amitriptyline is a

Answer 13

tricyclic antidepressants