Migraine and Anti Migraine Druigs

8/4/2019 Migraine and Anti Migraine Druigs

1/15

MIGRAINE ANDANTIMIGRAINE DRUIGS

BY

M.SARANYA


2/15

INTRODUCTION

Migraine is common anddebilitating condition affecting 10-15% ofpeople, Migraine is a mysterious

disorder characterized by moderate tosevere headaches, and nausea althoughthe cause is not understood. which

comes in attacks lasting 4-48 hours. It isabout three times more common inwomen than in men.
http://en.wikipedia.org/wiki/Headachehttp://en.wikipedia.org/wiki/Nauseahttp://en.wikipedia.org/wiki/Nauseahttp://en.wikipedia.org/wiki/Headache


3/15

Signs and symptoms

Migraine attack consist of an initial visualdisturbance (the aura), in which a flickeringpattern, followed by blind spot (a scintillatingscotoma), progresses gradually across anarea of the visual field.

The visual disturbance is followed ,about 10minutes later, by a severe throbbingheadache, starting unilaterally.

And often associated with nausea, vomiting,sensitivity to light and sound, flashes of light,vertigo, loose motions and other symptoms.


4/15

Two major types are

Migraine without aura(common migraine) involvesmigraine headaches that are not accompanied by anaura (visual disturbance).

Migraine with aura(classical migraine )usually

involves migraine headaches accompanied by an auraor other neurological symptoms.

Two other varieties are Familial hemiplegic migraineand Sporadic hemiplegic migraine, Another variety isbasilar-type migraine, where a headache and aura areaccompanied by difficulty speaking, vertigo, ringing inears, or a number of other brainstem-relatedsymptoms, but not motor weakness.
http://en.wikipedia.org/wiki/Familial_hemiplegic_migrainehttp://en.wikipedia.org/wiki/Sporadic_hemiplegic_migrainehttp://en.wikipedia.org/wiki/Basilarhttp://en.wikipedia.org/wiki/Dysarthriahttp://en.wikipedia.org/wiki/Vertigo_%28medical%29http://en.wikipedia.org/wiki/Tinnitushttp://en.wikipedia.org/wiki/Tinnitushttp://en.wikipedia.org/wiki/Tinnitushttp://en.wikipedia.org/wiki/Tinnitushttp://en.wikipedia.org/wiki/Vertigo_%28medical%29http://en.wikipedia.org/wiki/Dysarthriahttp://en.wikipedia.org/wiki/Basilarhttp://en.wikipedia.org/wiki/Sporadic_hemiplegic_migrainehttp://en.wikipedia.org/wiki/Familial_hemiplegic_migraine


5/15

Cause and Triggers

Cause The underlying cause of migraines is unknown. There

are, however, many biological events that have beenclinically associated with migraine.

Triggers Migraines may be induced by triggers, with some

reporting it as an influence in a minority of cases andothers the majority.

Many things have been labeled as triggers, however

the strength and significance of these relationships areuncertain. Common triggers quoted are stress,hunger, and fatigue (these equally contribute totension headaches).
http://en.wikipedia.org/wiki/Tension_headacheshttp://en.wikipedia.org/wiki/Tension_headaches


6/15

Pathophysiology

Both vascular and neural influences causemigraines.

stress triggers changes in the brain

These changes cause serotonin and/orhistamine to be released

blood vessels constrict and dilate

chemicals including substance P irritatenerves and blood vessels causing neurogenicinflammation and pain.
http://en.wikipedia.org/wiki/Neurogenic_inflammationhttp://en.wikipedia.org/wiki/Neurogenic_inflammationhttp://en.wikipedia.org/wiki/Neurogenic_inflammationhttp://en.wikipedia.org/wiki/Neurogenic_inflammation


7/15

Cont..

The Vascular theory holds that initialvasoconstriction or shutting of blood throughcarotid arterio -venous anastomoses produces

cerebral ischaemia and starts the attack. The neurogenic theory considers it to be a

spreading depression of cortical electricalactivity followed by vascular phenomena.


8/15

Postulated pathogenesis of migraine

Peripheral mechanisms

5-HT Dilatation of

receptor extracerebral vessels

5-HT Vascular NO 5-HT1D(-) sensory nerve

endothelium agonists discharge

sensitisation of

5-HT (-) sensory nerve

Antagonists 5-HT(-)

agonists

Release of mediators

(prostaglandins,kinins,etc) Neuropeptide release

(CGRP,SP)

NASIDS (-)

Neuroinflammation aura and pain


9/15

Central mechanism

sensory nerve discharge

(-)5-HT1D agonist

central pain sensitisationUnknown factors aura & painspreading depression


10/15


11/15

Antimagraine drugs

Mild: Simple analgesics (e.g.

aspirin,paracetamol,with or without

metoclopramide to hasten absorption )

NSAIDs or their combinations (+antiemetic)

Moderate:

NSAIDs combinations /ergot alkaloids /sumatriptan (+antiemetic)


12/15

Severe

Ergot alkaloids/

Prophylaxis


13/15

Tricyclic antidepressants (e.g.amitriptyline).

Clonidine, an alpha2-adrenoceptoragonist.

Calcium channel blockers :(e.g.Flunarizine, Dihydropyridines,verapamil)


14/15

Reference

Goodman & Gilman's-manual ofpharmacology and therepuetics

Essentials of medical pharmacology-KD Tripathi.

www.wikipedia.com


15/15

Documents

Migraine and Anti Migraine Druigs