Migraine is a complex disorder characterized by recurrent episodes of headache.
Most often unilaterally ( affect one side of the head).
Migraine is most common in women and has a strong genetic component.
FACTORS THAT PRECIPITATE MIGRAINE
1. Hormonal changes especially those accompanying menstruation,pregnancy and ovulation
3.excessive or insufficient sleep
5.Medications such as contraceptives and vasodilators.
6.exposure to bright or fluorescent lighting
7.strong odors such as those of perfumes
8. Lack of exercise
9.Fasting or skipping meals
10. Weather changes
SIGNS AND SYMPTOMS
Aggravation by movement
Photophobia and phonophobia
FIRST LINE THERAPY DRUG FOR MIGRAINE
Triptans are the first-line therapies for patients whose migraine attack does not respond to analgesics.
Example of triptans include: Sumatriptan, naratriptan, rizatriptan.
The onset of action of triptans is within 20-60 minutes
In patients with severe headache, or nausea/vomiting, subcutaneous Sumatriptan should be considered as it has the fastest onset
All triptans have similar effectiveness and tolerability for acute migraine treatment.
As individual patients may have different responsiveness to different triptans, trial for different triptans may be effective in patients who failed to respond to one of the triptans.
CONTRAINDICATIONS OF TRIPTANS
Due to its vasoconstrictive mechanism, triptans are contraindicated in patients with:
1.poorly controlled hypertension
3.severe hepatic and renal impairment
6.coronary artery disease
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