Migraine Meds

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Author:
Snooze
ID:
139750
Filename:
Migraine Meds
Updated:
2012-03-05 04:46:43
Tags:
migraine
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Description:
Brands/generics/formulations/controlled of migraine meds
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  1. Migranal
    DHE

    Nasal spray

    Also: IM, SC, IV
  2. Butorphanol
    Stadol NS

    Nasal spray

    CIV
  3. Almotriptan
    Axert

    PO
  4. Frovatriptan
    Frova

    PO
  5. Naratriptan
    Amerge

    PO
  6. Eletriptan
    Relpax

    PO
  7. Rizatriptan
    Maxalt

    PO, Disintegrating tab
  8. Sumatriptan
    Imitrex

    PO, SQ, nasal
  9. Sumatriptan/Naproxen
    Treximet

    PO
  10. Zolmitriptan
    Zomig

    PO, disintegrating, nasal
  11. Cafergot
    Caffeine

    Ergotamine
  12. Fiorinal vs Fioricet
    Fiorinal: ASA, caffeine, butalbital; CIII

    Fioricet: APAP, caffeine, butalbital
  13. Midrin
    APAP, isometheptene, dichloralphenazone; CIV
  14. CI of Midrin w/....
    Non-selective MAOI's

    i.e Phenelzine, Tranylcypromine, etc
  15. CI of Cafergot w/....
    Potent 3A4 inhibitors

    i.e. Macrolides, PI's, -azoles, Fluvoxamine, Nefazodone
  16. ALL triptans are CI w/..... (3)
    • Ischemic heart dz
    • Ergotamines (w/in 24hrs)
    • MAOI's (serotonin syndrome) - except "FEN" = Frovatriptan, Eletriptan, Naratriptan
  17. Triptans cannot be used w/non-selective MAOI's EXCEPT:
    "FEN"

    • Frovatriptan
    • Eletriptan
    • Naratriptan
  18. Which of the triptans are slower-acting (2-3hrs onset after PO)? The rest are 1/2hr onset PO.
    • Naratriptan
    • Frovatriptan

    Slower-acting but longer DOA
  19. If tolerability is a problem, which triptans may be used?
    The two "A's"

    Almotriptan (Axert)

    Naratriptan (Amerge)
  20. When must you reduce dose by 50% of:
    Naratriptan
    Rizatriptan
    ?
    • Amerge - when CrCL<60ml/min
    • Malxalt - when taken with propanolol
  21. Which of the migraine medications is highly emetogenic?
    Ergotamine
  22. Propanolol

    Which triptan will have increased [ ] w/Propanolol?
    Inderal

    FDA-indicated for prophylaxis migraine

    Will raise rizatriptan levels; Decrease dose by 50%
  23. Timolol
    Blocadren

    FDA-indicated for migraine prophylaxis
  24. Nadolol
    Corgard

    Not FDA-indicated for migraine prophylaxis
  25. What are the 5 preferred BB's for migraine prophylaxis?
    • "PT MAN"
    • Propanolol (Inderal)
    • Timolol (Blocadren)
    • Metoprolol (Lopressor)
    • Atenolol (Tenormin)
    • Nadolol (Corgard)
  26. What are the 5 preferred TCA's for migraine prophylaxis?
    • Amitriptyline (Elavil)
    • Nortriptyline (Pamelor)
    • Desipramine (Norpramin)
    • Doxepin (Sinequan)
    • Trazodone (Desyrel)
  27. Which TCA's are least sedating and least anticholinergic?
    • Nortriptyline (Pamelor)
    • Desipramine (Norpramin)
  28. Amitriptyline
    Elavil

    Well studied
  29. Nortriptyline
    Pamelor
  30. Desipramine
    Norpramin
  31. Doxepin
    Sinequan

    Very sedating
  32. Trazodone
    Desyrel

    Conflicting data
  33. 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)
  34. Divalproex sodium
    Depakote
  35. What are the 4 1st-line drug classes/drugs for migraine Px?
    • BB's
    • Topamax
    • VPA
    • TCA's
  36. What are the 2nd line drugs/drug classes for migraine Px?
    • Gabapentin
    • Lamotrigine
    • Zonisamide (Zonegran, anticonvulsant)
    • CCB's
    • SSRI's
  37. What are the 3 preferred CCB's?
    • Verapamil (Calan, Isoptin SR, Verelan)
    • Amlodipine
    • Diltiazem

    Dont use nifedipine - worsens HA

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