Antimigraine Drugs
TERMS
□ ergotamine (Ergomar)
□ sumatriptan (Imitrex)
QUICK LOOK AT THE CHAPTER AHEAD
There are many types of migraine headache, but severe pain is something they all have in common. Arterial dilation is believed to be the cause of migraines. The Ergot Derivatives were the first group of drugs that were used to treat migraine headaches, and the second group, the Triptans, were developed in the 1990s.1 The Triptans have proven to be very effective with less side effects than the Ergots.
Table 25-1 Antimigraine Drugs | |||||||||
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ANTIMIGRAINE DRUGS CLIENT TEACHINGErgot Derivatives
Do not breast-feed.
Take drug as soon as migraine headache begins.
Must talk with physician before increasing dose
The following must be reported to physician: nausea, vomiting, irregular heartbeat, muscle pain or weakness in extremities, and cold fingers.
Extremities must be kept warm.
After taking drug, lie down in dark, quiet room for 2-3 hours.
Take drug as soon as migraine headache begins.
After taking drug, lie down in dark, quiet room for 2-3 hours.Triptans
Do not breast-feed.
Must learn how to use autoinjector for SC dose.
Do not take within 24 hours of an Ergot Derivative or any other Triptan.
Contact physician if experiencing angina or hypersensitivity.
Do not take any new prescription or OTC drug until checking with physician.
Do not take within 24 hours of an Ergot Derivative or any other Triptan.
Contact physician if experiencing angina or hypersensitivity.
ACTIONErgot Derivatives
Act directly on the cranial and peripheral smooth muscles and has depressant effect on central vasomotor centers
Triptans
Vasoconstrict the cranial carotid arteries
USEErgot Derivatives
Prevent/stop migraine and other vascular headaches
Triptans
Treatment of migraine headaches
ADVERSE EFFECTS AND SIDE EFFECTSErgot Derivatives
Pregnancy category X
CNS: Drowsiness, confusion
CV: Intermittent claudication, irregular pulse
Derm: Cold skin
GI: Nausea, vomiting
Other: Muscle weakness
INTERACTIONSErgot Derivatives
Increased risk of gangrene and peripheral ischemia if taken with beta blockers
Triptans
Increased risk of vasoconstriction if taken within 2 weeks of an MAOI
Increased vasoactivity if combined with an Ergot Derivative
Increased toxicity if taken with St. John’s Wort
CONTRAINDICATIONSErgot Derivatives
Pregnancy
Sepsis
Hypersensitivity
Liver or kidney disease
Severe pruritis
History of cardiac problems
Hypertension
Malnutrition
Triptans
Pregnancy
Use in children
Hypersensitivity
Coronary artery disease
NURSING IMPLICATIONSErgot Derivatives
Give SL.
Tablet cannot be crushed.
No smoking, eating, or drinking while tablet is in place
Nausea and vomiting are very common and may require an antiemetic.
Clients on high doses for long periods need assessment for increased headaches.
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