10.10 Antimigraine Medications
Migraines are a neurological disorder characterized by severe and recurring headaches and other symptoms such as sensitivity to light, sound, and smells, and nausea. The treatment of migraines includes both acute and preventative medications. The following is a list of some common medications used to treat migraines.
Triptans
Mechanism of Action: Triptans bind to serotonin (5-HT) receptors, specifically the 5-HT1B and 5-HT1D receptors. Activation of these receptors leads to vasoconstriction of the dilated blood vessels in the brain, which is thought to be one of the key factors involved in migraines.
Indication: Triptans inhibit the release of pro-inflammatory neuropeptides, such as substance P and calcitonin gene-related peptide (CGRP), which are involved in the pain and inflammation associated with migraines. In addition, they may also reduce the sensitivity of the trigeminal nerve, which is a major source of pain in migraines.
Nursing Considerations: Triptans can be administered orally, subcutaneously, or as a nasal spray. The medication should be administered at the onset of the migraine and may be repeated once after two hours, but not to exceed 200 mg/per day.
Side Effects/Adverse Effects: Adverse effects of triptans include dizziness, vertigo, somnolence, nausea, vomiting, chest discomfort, and angina.
Health Teaching & Health Promotion: Advise the client to take the medication as soon as possible after the onset of the migraine symptoms. Additionally, it is important to acknowledge lifestyle changes that may be of benefit to help prevent migraine attacks such as stress management techniques, exercise, and avoidance of triggers.
Now let’s take a closer look at sumatriptan in the medication grid Table 10.10a.[1]
Table 10.10a Sumatriptan Grid
| Class/Subclass | Prototype/Generic | Nursing Considerations | Therapeutic Effects | Side/Adverse Effects |
|---|---|---|---|---|
| Triptans | sumatriptan | Administer at onset of migraine, may repeat once after 2 hours, but not to exceed 200 mg/day. May be administered PO, nasal spray, or injection | Relieves symptoms of migraine headaches, including pain, nausea, and sensitivity to light and sound | Dizziness, vertigo, somnolence, nausea, vomiting, chest discomfort, and angina. Can cause a severe allergic reaction |
Ergot Alkaloids
Mechanism of Action: Ergot alkaloids work by narrowing the blood vessels within the brain.
Indication: Ergot alkaloids are used for the acute treatment of migraines.
Nursing Considerations: Ergot alkaloid medications may be administered orally, rectally, sublingually, or as a nasal spray.
Side Effects/Adverse Effects: Side effects may include nausea, vomiting, and abdominal pain.
Health Teaching & Health Promotion: Medication should be taken exactly as prescribed by the health care provider. Do not exceed the prescribed dose or take the medication for longer than prescribed. Clients should avoid the use of alcohol while taking the medications. Abrupt cessation of medication may elicit withdrawal symptoms such as headache, nausea, vomiting, and muscle pain.
Now let’s take a closer look at ergotamine in the medication grid Table 10.10b.[2]
Table 10.10b Ergotamine
| Class/Subclass | Prototype/Generic | Nursing Considerations | Therapeutic Effects | Side/Adverse Effects |
|---|---|---|---|---|
| Ergot Alkaloid | ergotamine | These medications should not be used in clients with coronary artery disease, peripheral vascular disease, hypertension, or renal or hepatic dysfunction | Narrow blood vessels within the brain reducing pressure | Nausea
Vomiting Abdominal pain |
- This work is a derivative of DailyMed by U.S. National Library of Medicine in the Public Domain. ↵
- This work is a derivative of DailyMed by U.S. National Library of Medicine in the Public Domain. ↵
