Questions and Answers
Which class of medications is known to stabilize nerve cell membranes in migraine treatment?
What potential side effect is associated with Butterbur as an herbal treatment for migraines?
What is the recommended hormonal therapy for menstrual migraines?
Which of the following is a characteristic of CGRP monoclonal antibodies?
Signup and view all the answers
What is a common side effect of magnesium supplementation in migraine treatment?
Signup and view all the answers
What should be considered about the use of abortive medications in migraine treatment?
Signup and view all the answers
What is a common side effect of Sumatriptan?
Signup and view all the answers
Which of the following foods is NOT mentioned as a migraine trigger?
Signup and view all the answers
What is the maximum daily dose of Sumatriptan?
Signup and view all the answers
Which abortive medication can be used during breastfeeding?
Signup and view all the answers
What is the main mechanism of action for Triptans?
Signup and view all the answers
What adverse effect is associated with Ergotamine?
Signup and view all the answers
Which combination drug is composed of Sumatriptan and Naproxen?
Signup and view all the answers
What is a contraindication for the use of Ergotamine?
Signup and view all the answers
Study Notes
Pathophysiology of Migraines
- Caused by abnormal brain activity that impacts nerve signals, chemicals, and blood vessels.
- Common triggers include hormonal changes, stress, specific foods, and environmental factors.
Foods that Trigger Migraines
- Aged cheeses
- Processed meats
- Chocolate
- Alcohol (particularly red wine)
- Caffeine
- Artificial sweeteners
Abortive Treatment Drug Classes
-
Triptans (e.g., Sumatriptan)
- Selective serotonin receptor agonists that mitigate inflammation and constrict blood vessels.
-
Sumatriptan:
- Side effects: bad taste, chest symptoms, coronary vasospasm, teratogenesis.
- Contraindicated in pregnancy, heart disease, and certain conditions (geriatric, severe liver disease, MAOIs within 2 weeks).
- Laboratory tests: liver function tests (LFTs), creatinine clearance.
- Maximum dosage: 20mg per day.
- Zolmitriptan: Available in oral and intranasal forms, may have an unpleasant taste.
- Frovatriptan: Notable for its long half-life of 26 hours.
-
Ergot Alkaloids (e.g., Ergotamine)
- Function through blood vessel constriction.
-
Ergotamine:
- Side effects: muscle pain, paresthesia, cold extremities, potential for physical dependence.
- Risk of severe vasoconstriction leading to peripheral vascular ischemia or gangrene.
- Contraindicated in hepatic/renal impairment and cardiovascular conditions (CAD, PVD) and in pregnancy.
- Black box warning against use with potent CYP inhibitors (protease inhibitors, azole antifungals, certain macrolides).
-
NSAIDs (e.g., Ibuprofen, Naproxen)
- Serve to reduce inflammation and relieve pain.
-
Treximet
- Combination product of Sumatriptan and Naproxen.
-
Ubrogepant
- Newer treatment, safe for use during breastfeeding; potential drug interactions include azoles, macrolides, fluoroquinolones, and grapefruit juice.
-
Rimegepant
- Functions as both abortive and preventive; prescribed as 75mg as needed or every other day for prevention.
Preventive Medication Drug Classes
-
Beta-blockers (e.g., Propranolol)
- Effective in reducing the frequency and severity of migraines.
-
Antiseizure Medications (e.g., Topiramate, Divalproex, Tiagabine)
- Stabilize nerve cell membranes.
-
CGRP Monoclonal Antibodies (e.g., Erenumab)
- Block calcitonin gene-related peptide to decrease migraine occurrences; administered subcutaneously once monthly.
- Atogepant: Oral form requiring renal dosing.
-
Antidepressants (e.g., Amitriptyline)
- Used for preventive treatment.
-
Botulinum Toxin
- Requires multiple injections; variable effectiveness and high cost.
Herbal Medications for Migraines
- Butterbur: Potential risk for liver toxicity.
- Feverfew: May cause gastrointestinal discomfort and mouth ulcers.
- Magnesium: Possible side effect is diarrhea.
- Riboflavin (Vitamin B2): Well-tolerated with minimal side effects.
Treatment for Menstrual Migraines
- NSAIDs and Triptans.
- Hormonal therapy, such as low-dose estrogen patches, recommended 3 days prior to menstruation.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Explore the pathophysiology of migraines and the various foods that can act as triggers. This quiz covers the physiological aspects and dietary influences on migraine occurrences. Understanding these factors can help in managing and preventing migraines effectively.
