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Question
7 out of 10
 

What is drug of choice for acute attack of migraine- (AIIMS May 2014)



A Methysergide

B Caffeine

C Amitriptyline

D Sumatriptan

Ans. D

Sumatriptan

Acute Attack Therapies for Migraine

1. NSAIDs are the drug of choice for early migraine

2. 5-HT1 Agonists:

a. Stimulation of 5-HT 1B/1D receptors can stop an acute migraine attack.

b. Ergotamine and dihydroergotamine are nonselective receptor agonists.

c. The triptans are selective 5-HT 1B/1D receptor agonists.

d. Sumatriptan affect Blood flow by decreasing cerebral vasodilatation. Example of triptans (e.g naratriptan, rizatriptan, eletriptan, sumatriptan, zolmitriptan, almotriptan, frovatriptan).

Extra Edge: Drug of choice of early stage acute attack of migraine = NSAID (Ref. Hari-18th ed., Pg 114)

3. Dopamine antagonists

Chlorpromazine, prochlorperazine, metoclopramide.

Preventive treatments in migraine (Ref. Hari-18th ed., Pg-121)

1. Pizotifen

2. Beta blocker: Propranolol

3. Tricyclic: amitriptyline Dothiepin, Nortriptyline

4. Anticonvulsants : Topiramate, Valproate, Gabapentin

5. Serotonergic drugs: Methysergide, Flunarizine

Drugs which are not effective as migraine prophylaxis: Verapamil, Nimodipine, Clonidine, SSRIS, fluoxetine

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