Mechanism of Action
This class of acute migraine medications works by blocking CGRP or its receptor, interrupting trigeminovascular activation without causing vasoconstriction.
What are CGRP antagonists? (-gepant, -umab)
Triptans and Ergots must be avoided in patients with comorbidities involving this body system.
What is the cardiovascular system?
The American College of Physicians recommends considering prophylactic therapy when patients experience at least this many headache days per month with impaired quality of life.
What is 6 days (or 2 migraine days with significant impairment)?
Triptans are serotonin receptor agonists that reduce acute migraine intensity via inhibition of CGRP release, modulation of trigeminocervical pain pathways and one additional mechanism responsible for its contraindications.
What is cranial vasoconstriction?
This preventative prescription would be the ideal choice for a patient with a BMI of 35 experiencing chronic migraines.
What is Topiramate? (Side Effects: parasthesia, weight loss, fatigue)
These two classes of medications represent first-line acute treatment options according to the American College of Physicians, with moderate to high strength of evidence.
What are triptans and NSAIDs?
Topiramate prevents migraines through multiple mechanisms including modulating these two types of voltage-gated channels, inhibiting glutamate receptors, and enhancing GABA activity.
What are sodium and calcium channels?
A patient presents with chronic hypertension and a history of >15 headaches/month lasting an average of 4 hours; this class of medication is a treatment option for both of their comorbidities.
What is a nonselective beta blocker? (propranolol)
According to recent guidelines, CGRP-targeted monoclonal antibodies should be offered to patients when established oral preventive treatments show no response after this duration of therapy.
What is 6 weeks OR upon experiencing intolerable adverse effects?