Which vascular changes can be observed before and during migraines?

Once chemicals are released, they move to the outer layer of your brain - the meninges - resulting to inflammation and swelling of blood vessels, leading to an increase in blood flow around the brain. This is probably the result of the throbbing, throbbing pain that most people experience during migraines.

What is the role of serotonin in migraine headaches?

Serotonin is a chemical that is needed for communication between nerve cells. It can lead to narrowing of blood vessels throughout the body. If serotonin or oestrogen levels change, the result is for some migraines. Serotonin levels can affect both sexes, while fluctuating oestrogen levels affect only women.

How is ergotamine used during a migraine attack?

Take ergotamine as soon as migraine symptoms starts. Place a tablet under your tongue and let it dissolve. Take 1 tablet every 30 minutes as needed. Do not use more than 3 tablets within 24 hour period.

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

The side effects are: Overdose can cause vomiting, confusion, drowsiness, weak wrists in your legs and arms, numbness and tingling or pain in your hands or feet, blue fingers or toes, fainting and seizures (convulsions).

The contraindications: high blood pressure, coronary heart disease, cerebral ischemia, lack of blood supply to the brain, Raynaud's phenomenon, a condition in which blood vessels contract too much with cold or tension, peripheral vascular disease, thrombophlebitis, an inflamed vein due to a blood clot

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

Currently, non-steroidal anti-inflammatory drugs (NSAIDs) and triptans (serotonin 5HT1B / 1D receptor agonists) are recommended for the acute treatment of migraine attacks. Metoclopramide or domperidone are useful for taking NSAIDs and triptans. In very severe attacks subcutaneous sumatriptan is the first choice

Migraine is a common neurological disorder with a serious socioeconomic burden. By blocking cyclo-oxygenase, non-steroidal anti-inflammatory drugs (NSAIDs) reduce the synthesis of prostaglandins, which are involved in the pathophysiology of migraine

Triptans are selective 5-HT1 receptor agonists, indicated in severe migraine attacks. These drugs work mainly by vasoconstriction in the cranial blood vessels. However, vasoconstrictive effects outside the central nervous system are also possible

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

First-line therapies for the prevention of migraine in adults include propranolol (Inderal), timolol (Blocadren), amitriptyline, divalproex (Depakote), sodium valproate and topiramate (Topamax)

 

The side effects

propanolol - fatigue

timolol - fatigue

amitriptyline - dry mouth

divalproex (Depakote) - sedation

topiramate (Topamax) - nausea

The precautions

There is strong evidence to support the use of metoprolol, timolol, propranolol, divalproex sodium, sodium valproate and topiramate for the prevention of migraines.