Migraine - Acute drug treatment
17 important questions on Migraine - Acute drug treatment
When are OTC drugs used for migraines? And what are they?
acetaminophen, aspirin, naproxen, Advil Migraine (only has ibuprofen).
combos: Excedrin Migraine (aspirin, acetaminophen, caffeine)
What drugs are not recommended for migraines due to decreased efficacy, abuse/dependence potential and risk of rebound headache (MOH)?
1st line for acute treatment of migraines
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Triptan warnings and side effects
Paresthesia (tingling/numbess), "triptan sensations" (pressure or heaviness in chest or pressure in the neck region)
Sumatriptan SC dosing
Zembrace: can repeat up to 4x/day
Preferred site is lateral thigh or upper arm
Sumatriptan intranasal dosing
Powder: 11 mg in each nostril using nosepiece, can repeat x1 after 2 hrs (max 44 mg/day)
Which triptans are approved for >/= 12 years old?
Which triptans are approved for >/= 6 years old?
Which triptan has the longest half life? Considered long acting? Shorter half life?
Long acting, slower onset- frovatriptan, naratriptan [choose if headache recurs after dosing, lasts long time or can be anticipated]
Shorter half life, faster onset- all other triptans
Which triptans are CI with MAO inhibitors (or within 2 weeks of stopping) due to increased triptan conc when used together?
What type of drug is an option for patients that do not benefit from a triptan?
Ergotamine BBW and CI
CI- uncontrolled htn, ischemic heart disease, pregnancy, use w/in 24 hrs of serotonin agonists (triptans) or other ergotamine drugs
Whats the difference in priming triptan nasal sprays and ergotamine nasal sprays?
Ergotamines- prime by pumping 4 times
Which CGRP is approved to prevent and treat acute migraine attacks?
Which CGRPs are only approved to treat acute migraine attacks?
Why is Lasmiditan (Reyvow) not CI in patients with CVD?
Why are butalbital products NOT recommended for treating acute migraines, even though they are popular?
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