Migraine or Headache

What’s a migraine

moderate or severe headache felt as a throbbing pain on 1 side of the head

What are the symptoms of a migraine

1.) N/V

2.) sensitivity to light or sound

3.) intense throbbing headache on one side of head

What are the aura migraine symptoms

1.) Visual disturbances

2.) Numbness or pins/needles

3.) Dizzy off balance

4.) Difficulty speaking

What are the treatments of migraines

1.) 5HT1 receptor agonists e.g. sumatriptan

2.) NSAIDs: Tolfenamic acid

3.) Prophylaxis of migraine: Propranolol, Antiepilpetic drugs, TCA, Pizotifen

What are the treatments for acute migraine attacks

1.) simple analgesic

2.) 5HT1 agonists

3.) antiemetics: metoclopramide/domperidone

4.) prophylaxis of migraines: propranol

What’s the MOA of 5HT receptor agonists

1.) acts on 5HT1 receptors on cranial arteries and veins to cause vasoconstriction

What’s the dose of 5HT1 receptor agonists

1.) take dose asap after onset followed by second dose at least 2 hours after if migraine recurs

2.) Don’t take second dose for same attack

What are the side effects of 5HT1 receptor agonists

coronary vasodilation

anaplylaxis

What are the contraindications of 5HT1

any heart complications

What are the patient counselling of 5HT1

Stop if intense tingling, heat or heaviness

pressure or tightness in part of the body

What are the treatment for cluster headache

1.) acute attacks: SC sumatriptan

2.) alternative: Zolmitraptan nasal spray, 100% oxygen

3.) prophylaxis: Verapamil, Lithium