Term
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Definition
| abnormal activation of trigemminal sensory nerve; assoc w. large release of inflam mediators |
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Term
| What serotonergic receptor is involved in tx of migraine? |
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Definition
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Term
| Mechanism of action: serotonergic agonist in migraines |
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Definition
1. reduce release of inflamm peptides by nerve endings (by activating 5HT1B/D which are present on nerve endings of cranial sensorry afferents) -> reducing activation of nociceptive fibers
2. reduce vessel wall stretch and prodxn of inflamm substances (constriction of meningeal vessels and reduces extravasation) |
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Term
| Mechanism of action: NSAIDs in migraine |
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Definition
| work centrally and may reduce sensitizing effects of PGs on trigemminal nerve endings |
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Term
| Drugs with the suffix "-triptan" are used to tx what? |
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Definition
| migraines (structurally related to serotonin) |
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Term
| Sumatriptan is what kind of drug? |
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Definition
| serotonergic agonist of 5HT1B/1D/1F receptors |
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Term
| Mechanism of action: sumatriptan |
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Definition
1. activates inhib presyn R's on CN V sensory n.-> reduced release of inflamm mediators & reduc their excitability
2. activates 5HT1 in CN V nucleus -> reduced synaptic transmission inter CN V nonciceptives and 2nd order neurons
3. 5HT1 act. in central pain pathways
4. 5HT1 act. in cerebral conductance vessels |
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Term
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Definition
| coronary circulation may be adversely affected; avoid in CAD or printzmetal angina |
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Term
| route of admin: sumatriptan |
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Definition
| oral, sc or IN for faster action |
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Term
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Definition
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Term
| what types of drugs are triptans incompatible with? |
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Definition
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Term
| Mechanism of action: ergotamine (what receptors are involved?) |
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Definition
| partial agonist activity at serotonergic, dopaminergic and adrenergic receptors |
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Term
| Side effects: ergotamines |
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Definition
DA receptor agonist -> emesis
5HT2/alpha1 Rs -> peripheral vasoconstriction (gangrene, thrombosis) and uterine contractions |
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Term
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Definition
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Term
| Route of adminis: ergotamines |
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Definition
| sublingually or suppository as it has very low and erratic oral bioavailability |
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Term
| Which migraine med is administered as a nasal spray? |
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Definition
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Term
| What kinds of ppl should not take erogtamines? |
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Definition
| pregnant, peripher vasc dz, HT, ischemic HD, renal or hepatic dz |
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Term
| Mechanism of action in tx of migraines: Metclopramide |
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Definition
| tx prominent sx of migraines: emesis by acting as a prokinetic |
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Term
| role of butalbital in tx of migraines |
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Definition
| a barbituate that can be used in mixture as a sedative with an ANALGESIC (aspirin) and CAFFEINE |
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Term
| draw back of using butalbital in tx migraines |
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Definition
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Term
| Combination analgesics are generally made of what 3 types of meds? |
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Definition
| a SEDATIVE + ANALGESIC + Vasoconscritor |
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Term
| How can propanolol & timolo be used in migraine tx? |
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Definition
| as prophylaxis (mechanism of protective effect is not known) |
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Term
| How can amitryptyline and nortryptyline be used in migraine tx? |
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Definition
| prophylaxis (unknown mechanism) |
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Term
| what kind of drug is valproate? what's it's role in migraine tx? |
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Definition
| anticonvulsant; prophylaxis |
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Term
| what kind of drug is topiramate? what's it's role in migraine tx? |
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Definition
| anticonvulsant, prophylaxis |
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Term
| what kind of drug is gabapentin? what's it's role in migraine tx? |
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Definition
| anticonvulsant; prophylaxis |
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Term
| what kind of drug is methysergide? what's it's role in migraine tx? |
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Definition
| semisynthetic ergot derivative; 3rd line drug in tx. of migraines |
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Term
| mechanism of action in migraine: methysergide |
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Definition
| although it's a 5HT R antagonist; it's activity in migraine may be due to a metabolite that has agonist activity at serotonergic/a1 receptors |
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Term
| why is methysergide a 3rd ling drug in tx of migraine? |
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Definition
| serious inflamm fibrosis of the lung, heart, or peritoneal cavity can occur |
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