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Management_of_Migraine:
Non-pharmacological Approach :
⁃Avoid triggers.
⁃Regular sleeping pattern.
Pharmacological Treatment:#Prophylactic:
Prophylactic treatment indicated if attacks occur >2-3 times a month:
1-[CGRP] Antagonists: binds to CGRP ligand blocking the effect of CGRP.
e.g:Ernumab / Fremanezumab given subcutaneous.
2-Antiepileptic(Valporic acid)
3-Antihypertensive(propranolo)4
-Antidepressant(Amitriptyline)
#Symptomatic_Relife (Abort Headache):
1-Triptants (e.g.,sumatriptan) are 5-HT1B ,5-HT1D) agonists.
2-Ergotamines (alpha -1 selective agonist and is an agonist of serotonin receptors e.g. (5-HT1B & 5-HT1D).
MOA: inhibit the release of neuropeptides from trigeminal.n by activating (5HT1B,5HT1D) receptors ,leading to vasoconstriction.
Triptans contraindications :1-ischemic stroke
2-pregnancy /HTN
3-Coronary artery disease.
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Reference:
Current Medical diagnosis.
#Abbrevations:
MOA: mechanism of action.
