Question 1

Which of the following is true of ergotamine for migraine prophylaxis?&#10;A) Caffeine enhances its absorption and onset of action.&#10;B) No more than five doses should be taken in any one week.&#10;C) Doses should be closely monitored due to the risk of rebound headaches and dependence.&#10;D) All of the above.

Accepted Answer

A) Caffeine is often added to ergotamine to enhance its absorption and onset of action.
B) Due to the risk of toxicity and dependence, no more than five doses of ergotamine should be taken in any one week.
C) Prolonged or excessive use of ergotamine may lead to rebound headaches and dependence. Therefore, doses should be closely monitored.

Question 2

In treating an acute migraine attack,sumatriptan should not be given with ergotamine because the combination may lead to:&#10;A) excessive bronchoconstriction.&#10;B) excessive vasoconstriction.&#10;C) gastrointestinal bleeding.&#10;D) excessive diuresis.

Accepted Answer

Sumatriptan and ergotamine are both vasoconstrictors and the combination can lead to excessive vasoconstriction, which can be dangerous, especially in patients with cardiovascular disease.

Question 3

First-line therapy for an acute migraine attack includes:&#10;A) triptans.&#10;B) paracetamol.&#10;C) ergotamine.&#10;D) tricyclic antidepressants.

Accepted Answer

paracetamol.

Question 4

Analgesic agents that are effective in treating mild to moderate acute migraine headaches include:&#10;A) ibuprofen and indomethacin.&#10;B) aspirin and paracetamol.&#10;C) piroxicam and sulindac.&#10;D) propranolol and ketamine.

Accepted Answer

Aspirin and paracetamol are both effective in treating mild to moderate acute migraine headaches. Ibuprofen and indomethacin are also commonly used, but may not be as effective in all cases. Piroxicam and sulindac are nonsteroidal anti-inflammatory drugs (NSAIDs) that may have some efficacy in migraine treatment, but they are not typically used as first-line agents. Propranolol and ketamine are not analgesic agents and therefore would not be appropriate choices for treating migraine pain.

Question 5

Which substance enhances the absorption of ergotamine?&#10;A) Apple juice&#10;B) Sumatriptan&#10;C) Dairy products&#10;D) Caffeine

Accepted Answer

Caffeine enhances the absorption of ergotamine by constricting blood vessels, which ultimately increases the effectiveness of the medication.

Question 6

Preventive therapies for migraine should be used for a period of:&#10;A) three to six days.&#10;B) three to six weeks.&#10;C) three to six months.&#10;D) six to twelve months.

Accepted Answer

Preventive therapies for migraine should be used for a period of three to six months to determine their effectiveness. This is because it may take several weeks for the medication to build up in the system and begin to work effectively. Also, a longer trial period is necessary to evaluate the impact of the medication on the frequency and severity of migraine attacks. After this period, the effectiveness of the medication can be evaluated and the treatment plan adjusted accordingly.

Question 7

How does metoclopramide assist in the treatment of an acute migraine?&#10;A) It decreases the incidence of nausea and vomiting.&#10;B) It increases the absorption of ergotamine.&#10;C) It decreases the rate at which ergotamine is excreted.&#10;D) It inhibits the isoenzyme of the cytochrome P450 system that metabolises ergotamine.

Accepted Answer

Metoclopramide is a dopamine antagonist that is commonly used to treat symptoms of nausea and vomiting associated with migraines. By reducing the incidence of nausea and vomiting, it can help to improve patient comfort during an acute migraine attack. It does not have any relevant effect on the absorption, metabolism, or excretion of ergotamine, which is a medication used to treat migraines that works through a different mechanism of action.

Deck 41: Medicines Used to Treat Migraine