-
Migranal
DHE
Nasal spray
Also: IM, SC, IV
-
Butorphanol
Stadol NS
Nasal spray
CIV
-
-
-
-
-
Rizatriptan
Maxalt
PO, Disintegrating tab
-
Sumatriptan
Imitrex
PO, SQ, nasal
-
Sumatriptan/Naproxen
Treximet
PO
-
Zolmitriptan
Zomig
PO, disintegrating, nasal
-
Cafergot
Caffeine
Ergotamine
-
Fiorinal vs Fioricet
Fiorinal: ASA, caffeine, butalbital; CIII
Fioricet: APAP, caffeine, butalbital
-
Midrin
APAP, isometheptene, dichloralphenazone; CIV
-
CI of Midrin w/....
Non-selective MAOI's
i.e Phenelzine, Tranylcypromine, etc
-
CI of Cafergot w/....
Potent 3A4 inhibitors
i.e. Macrolides, PI's, -azoles, Fluvoxamine, Nefazodone
-
ALL triptans are CI w/..... (3)
- Ischemic heart dz
- Ergotamines (w/in 24hrs)
- MAOI's (serotonin syndrome) - except "FEN" = Frovatriptan, Eletriptan, Naratriptan
-
Triptans cannot be used w/non-selective MAOI's EXCEPT:
"FEN"
- Frovatriptan
- Eletriptan
- Naratriptan
-
Which of the triptans are slower-acting (2-3hrs onset after PO)? The rest are 1/2hr onset PO.
Slower-acting but longer DOA
-
If tolerability is a problem, which triptans may be used?
The two "A's"
Almotriptan (Axert)
Naratriptan (Amerge)
-
When must you reduce dose by 50% of:
Naratriptan
Rizatriptan
?
- Amerge - when CrCL<60ml/min
- Malxalt - when taken with propanolol
-
Which of the migraine medications is highly emetogenic?
Ergotamine
-
Propanolol
Which triptan will have increased [ ] w/Propanolol?
Inderal
FDA-indicated for prophylaxis migraine
Will raise rizatriptan levels; Decrease dose by 50%
-
Timolol
Blocadren
FDA-indicated for migraine prophylaxis
-
Nadolol
Corgard
Not FDA-indicated for migraine prophylaxis
-
What are the 5 preferred BB's for migraine prophylaxis?
- "PT MAN"
- Propanolol (Inderal)
- Timolol (Blocadren)
- Metoprolol (Lopressor)
- Atenolol (Tenormin)
- Nadolol (Corgard)
-
What are the 5 preferred TCA's for migraine prophylaxis?
- Amitriptyline (Elavil)
- Nortriptyline (Pamelor)
- Desipramine (Norpramin)
- Doxepin (Sinequan)
- Trazodone (Desyrel)
-
Which TCA's are least sedating and least anticholinergic?
- Nortriptyline (Pamelor)
- Desipramine (Norpramin)
-
Amitriptyline
Elavil
Well studied
-
-
-
Doxepin
Sinequan
Very sedating
-
Trazodone
Desyrel
Conflicting data
-
What are the two preferred SSRI's for migraine prophylaxis (2nd line)? Which 1 of the 2 has longest t1/2?
- Fluoxetine (Prozac) - longest half life
- Paroxetine (Paxil)
-
Divalproex sodium
Depakote
-
What are the 4 1st-line drug classes/drugs for migraine Px?
-
What are the 2nd line drugs/drug classes for migraine Px?
- Gabapentin
- Lamotrigine
- Zonisamide (Zonegran, anticonvulsant)
- CCB's
- SSRI's
-
What are the 3 preferred CCB's?
- Verapamil (Calan, Isoptin SR, Verelan)
- Amlodipine
- Diltiazem
Dont use nifedipine - worsens HA
|
|