Drugs for migraine head ache, antipsychotic drugs,anti neuralgia,anti seizure drug
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Module
Pharmacology
Institution
Book
Pharmacology for Nurses
ANTIMIGRAINE
These drugs are medications intended to reduce the effect or intensity of migraine headache. They include drugs for the treatment (abortive) of acute migraine symptoms as well as drugs for the prevention of migraine attack.
Migraine is a headache of varying intensity, usually accomp...
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Clayton: Basic Pharmacology for Nurses, 14th Edition Test Bank-Questions with Answer Rationales (Already Graded A)
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3. ANTIMIGRAINE
These drugs are medications intended to reduce the effect or intensity of
migraine headache. They include drugs for the treatment (abortive) of acute
migraine symptoms as well as drugs for the prevention of migraine attack.
Migraine is a headache of varying intensity, usually accompanied by nausea and
sensitivity to light or sound.
The main cause is unknown; however, it is due to dilation and inflammation of
cephalic arteries and intracranial extra cerebral arteries.
Mechanism of Action: Abortive anti migraine drugs act by constricting the dilated
arteries through stimulation of serotonin 1B receptor. The preventive anti
migraine drugs act by increasing the tone of extra cranial arteries, inhibiting the
mechanism of neurogenic inflammation or inhibiting pain transmission within
CNS.
Indications: Migraine, hypotension, severe uncontrolled headache, acute attack
of migraine, cluster headache
Side Effects: Dizziness, weakness, rhinitis, hypertension, nausea and vomiting,
angina pectoris
Types of anti migraine:
There are two main types as; Triptans and Ergotamine.
Triptans: Prescription drugs such as sumatriptan (Imitrex) and rizatriptan (Maxalt)
are used to treat migraine because they block pain pathways in the brain. Taken
as pills, shots or nasal sprays, they can relieve many symptoms of migraine.
i. Sumatraptin: 25-50mg orally and 6mg may be repeated after 1hr, not
exceeded 12mg/day.
, ii. Almotriptan: 12.5mg orally soon after the onset and repeated 2hrs if
migraine reoccur.
Ergotamine: (DHE 45), available as a nasal spray or injection, this drug is most
effective when taken shortly after the start of migraine symptoms for migraines
that tend to last longer than 24 hours. Side effects can include worsening of
migraine related vomiting and nausea.
i. Dihydroergotamine: 1-2mg orally and to be repeated every 30mins to
maximum of 6mg
ii. Methysergide: 4-8mg/Day orally In Divided Dose.
iii. Cafergot: 6mg/day and then 10mg PRN.
Nursing Implications
Advice patient not operate machine
Monitor vital signs with emphasis on BP and Pulse
Give with caution in patient with renal/hepatic impairment
Ensure correct dose and route of drug administration
Do not administer to hypersensitive patient
Encourage bed rest to minimize the rate of dizzness.
They might not be safe for those at risk of a stroke or heart attack
People with coronary artery disease, high blood pressure, or kidney or liver
disease should avoid dihydroergotamine.
Note That:
Lasmiditan (Reyvow). This newer oral tablet is approved for the treatment
of migraine with or without aura. In drug trials, lasmiditan significantly
improved headache pain
Ubrogepant (Ubrelvy). This oral calcitonin gene-related peptide receptor
antagonist is approved for the treatment of acute migraine with or without
aura in adults. It's the first drug of this type approved for migraine
treatment
4. CGRP INHIBITORS
CGRP stand for calcitonin gene related peptide. These drugs are also called
calcitonin gene related peptide blockers/antagonist.
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