• Which vascular changes can be observed before and during migraines?

Vasodilatation

• What is the role of serotonin in migraine headaches?

Serotonin vasoconstricts the nerve endings and blood vessels and affects nociceptive pain.

• How is ergotamine used during a migraine attack?

It is a 5HT1_D  partial antagonist of intracranial arteries and inhibits trigeminal nerve transmission. It should be used at first sign of migraine.

• Which side-effects are experienced with ergotamine use? Which contra‑indications exist for using ergotamine?

Side effects: Nausea, Vomiting, diarrhoea, hallucinations, gangrene.

Contra-indictaions: Pregnancy, hypertension, liver and kidney impairment.

• Which other drugs can be used for an acute migraine attack?  What is the action of all of these drugs?

Aspirin, Paracetamol, Metoclopramide, Cyclizine , Sumatriptan

• Name the drugs which can be used for migraine prophylaxis, as well as their specific side effects and precautions

Drugs used for migraine prophylaxis: Propranolol, Clonidine, Verapamil, Valproic acid, Pizotifen.

Side effects: Drowsiness, Fatigue, Weight gain