Study Set Content:
Appetite suppression appears to be associated with
agonist action at (blank) in the central nervous system
5-HT 2C receptors
are used
almost exclusively for migraine headache.
5-HT 1D/1B agonists triptans, e.g., sumatriptan,
in its “classic” form is characterized by an aura
of variable duration that may involve nausea, vomiting,
visual scotomas or even hemianopsia, and speech
abnormalities; the aura is followed by a severe throbbing
unilateral headache that lasts for a few hours to 1-2 days.
Migraine
“Common” migraine lacks the (blank), but the
headache is similar.
aura phase
Migraine involves the
trigeminal nerve distribution to
intracranial
These
nerves realease peptide neurotransmitters, especially
(blank), an extremely
powerful vasolidator. Substance P and neurokinin A may
also be involved.
calcitonin gene-related peptide (CGRP)
may
also be involved.
Substance P and neurokinin A
caused by this perivascular
edema may be the immediate cause of activation of pain
nerve endings in the dura.
The mechanical stretching
The onset of headache is sometimes associated with a
marked increase in amplitude of (blank), and relief of pain by administration of effective
therapy is sometimes accompanied by diminution of the
temporal artery
pulsations
In addition to the triptans, these include
ergot alkaloids,
nonsteroidal anti-inflammatory analgesics agents,
β-adrenoceptor blockers,
calcium channel blockers,
tricyclic antidepressants and
SSRIs, and
several antiseizure agents.
Furthermore, some of these drug groups are
effective only for (blank) and not for the acute attack.
prophylaxis
may activate 5-HT 1D/1B receptors on
presynaptic trigeminal nerve endings to inhibit the release
of vasodilating peptides, and antiseizure agents may
suppress excessive firing of these nerve endings.
triptans, the ergot alkaloids, and the
antidepressants
the vasoconstrictor actions of (blank) may prevent dilation and stretching of the pain endings.
direct 5-HT agonists
and its congeners are currently first-line
therapy for acute severe migraine attacks in most
patients. However, they should not be used in patients at
risk for coronary artery disease.
Sumatriptan
Anti-inflammatory analgesics such as (blank) are not often helpful in controlling the pain of
migraine.
aspirin and
ibuprofen
For patients with very severe nausea and vomiting,
parenteral (blank) may be helpful.
metoclopramide
have been found to be effective for
the prophylaxis of migraine in some patients. They are of
no value in the treatment of acute migraine.
Propranolol, amitriptyline, and some calcium
channel blockers
The anticonvulsants(blank) have
also been found to have prophylactic efficacy in many
migraine patients.
valproic acid and topiramate
appears to have modest efficacy as
prophylaxis against migraine.
Verapamil
a 5-HT 4 agonist, was used in the treatment
of gastroesophageal reflux and motility disorders.
Because of toxicity, it is now available only for
compassionate use in the USA.
Cisapride,
