Migraine medications
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Migraine medications
Subspeciality surgery
Cardiothoracic surgery
Coronary artery disease: Clinical (To be retired)
Valvular heart disease: Clinical (To be retired)
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Adrenergic antagonists: Beta blockers
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Anatomy clinical correlates: Trigeminal nerve (CN V)
Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves
Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves
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Anatomy clinical correlates: Bones, fascia and muscles of the neck
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Antihistamines for allergies
Neurosurgery
Stroke: Clinical (To be retired)
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Headaches: Clinical (To be retired)
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Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves
Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves
Anatomy clinical correlates: Trigeminal nerve (CN V)
Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves
Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves
Anatomy clinical correlates: Vertebral canal
Anatomy clinical correlates: Spinal cord pathways
Anatomy clinical correlates: Cerebral hemispheres
Anatomy clinical correlates: Anterior blood supply to the brain
Anatomy clinical correlates: Cerebellum and brainstem
Anatomy clinical correlates: Posterior blood supply to the brain
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Nonbenzodiazepine anticonvulsants
Migraine medications
Osmotic diuretics
Antiplatelet medications
Thrombolytics
Ophthalmology
Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review
Eye conditions: Retinal disorders: Pathology review
Eye conditions: Inflammation, infections and trauma: Pathology review
Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves
Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves
Anatomy clinical correlates: Eye
Orthopedic surgery
Joint pain: Clinical (To be retired)
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Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Axilla
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Anatomy clinical correlates: Median, ulnar and radial nerves
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Anatomy clinical correlates: Inguinal region
Androgens and antiandrogens
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Vascular surgery
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Aortic aneurysms and dissections: Clinical (To be retired)
Anatomy clinical correlates: Anterior and posterior abdominal wall
Adrenergic antagonists: Beta blockers
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Thrombolytics
Assessments
Migraine medications
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Migraine medications
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Sumatriptan p. 567
cluster headaches p. 536
coronary vasospasm with p. 249
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Transcript
Content Reviewers
Yifan Xiao, MDContributors
Elizabeth Nixon-Shapiro, MSMI, CMI
Victoria S. Recalde, MD
Evan Debevec-McKenney
Tanner Marshall, MS
Migraine medications include a wide variety of drugs used to treat a specific type of headache called migraine.
Migraines are the second most common primary headache.
They’re often preceded by symptoms like irritability, depression, and fatigue that can begin hours to days before the headache itself. Sometimes there can be an aura where people experience strange smells, lights, visual disturbances, or even hallucinations before the onset of the migraine.
The migraine itself usually feels like a pounding or pulsating, typically localized to one side of the head and can last from hours to days.
As if this was not bad enough, these headaches tend to come with nausea and vomiting, irritability, and pain or discomfort with lights, sounds, and smells called photophobia, phonophobia, and osmophobia, respectively.
During childhood, individuals can have nausea and vomiting without the headaches; and that’s called an abdominal migraine.
After a migraine is over, it can leave people feeling sore at the location of the pain and generally fatigued.
To remember the main features of migraines, you can use the mnemonic POUND, where P stands for pulsatile headache, O stands for one-day duration, U stands for unilateral, N for nausea, and D for disabling.
Although the underlying mechanism causing migraines isn’t well understood, there are some clues.
Concentrations of the neurotransmitter, serotonin, increase during the aura, triggering vasoconstriction, and then decrease to lower-than-normal levels during the migraine attack, triggering vasodilation. This change in the blood vessel size may be a trigger for pain receptors, causing the headache.
The initial vasoconstriction may also trigger cortical spreading depression, which is a phenomenon when the brain becomes hypersensitive to certain stimuli like lights, sounds, and smells.
Migraines are often associated with specific triggers like the smell of cigarette smoke, foods like chocolate or cheese, and drinking wine.
Sources
- "Katzung & Trevor's Pharmacology Examination and Board Review,12th Edition" McGraw-Hill Education / Medical (2018)
- "Rang and Dale's Pharmacology" Elsevier (2019)
- "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
- "Treatment of acute migraine headache" Am Fam Physician (2011)
- "Migraine Headache Prophylaxis" Am Fam Physician (2019)
- "Spotlight on Anti-CGRP Monoclonal Antibodies in Migraine: The Clinical Evidence to Date" Clin Pharmacol Drug Dev (2017)
- "Triptans and ergot alkaloids in the acute treatment of migraine: similarities and differences" Expert Review of Neurotherapeutics (2013)
- "The pathophysiology of migraine: implications for clinical management" Lancet Neurol (2018)
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