Migraine 2
Terms
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- Sumatriptan
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Serotonin analog that activates 5-HT receptors in brain to constrict vessles and reduce production of inflammatory substances
Reduces headaches, nausea/vomiting, pain - Side Effects of Sumatriptan
- May effect coronary circulation
- Second generation triptans
- high BBB penetrance and more effective
- First dosing of sumatriptan
- Give in physicians office to monitor for Printzmetal's angina
- Ergotamine and dihydroergotamine
- Older migraine drugs that activate serotonin, DA and alpha adrenergic receptors.
- Side Effects of ergotamines
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alpha ago causes vasoconstriction and uterine contractions
DA ago may cause nausea and vomitting
Dependence may develop - Administratin of dihydroergotamine
- Intranasal or iv, im
- Contraindications for ergotamines
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Pregnancy
Peripheral vascular disease
ischemic HD
renal or hepatic disease - Methylsergide
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3rd line migrain b/c can cause inflammatory fibrosis. drug holidays needed
metabolite is setonergic and alpha 1 agonist - "Other" migrain drugs
- NSAIDS, acetomenophen, propranolol, amitriptyline, Valproate, and butalbital