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Old 08-01-2012
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Drug The most appropriate headache prophylaxis

For 9 months, a 34-year-old woman has been experiencing left-sided pulsatile headaches. Before each headache attack, she feels disoriented and sees bilateral flashes of light. The pain is always unilateral and is often associated with nausea, vomiting, and photophobia. Which of the following is the most appropriate medication for headache prophylaxis for this patient?

a) Ergonovine
b) Dihydroergotamine
c) Ondansetron
d) Propranolol
e) Sumatriptan
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Old 08-01-2012
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propanolol
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Old 08-01-2012
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E is a better choice. you could also give BB.
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Old 08-01-2012
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E...i don't think beta blockers should be used for prophylaxis
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Old 08-01-2012
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The best preventive therapy for migraine is propranolol. Ergotamine and Triptans can interrupt the headache while it is happening. But for prevention it is propranolol.
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Old 08-01-2012
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d) Propranolol
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Old 08-02-2012
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Correct Answer correct answer :)

The answer is d) Propranolol
Propranolol and other beta-blockers are often used to prevent migraine headaches.


As for B) - Dihydroergotamine, a semisynthetic ergot alkaloid, is given parenterally or intranasally to treat acute migraine headaches.

As for E) - Sumatriptan and other triptan drugs are serotonin 5-HT1B/D receptor agonists widely used to treat an acute migraine headache.
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Old 08-02-2012
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Thank you casandra
Never figured out the prophylaxis and treatment use of different drugs.

Do you know why propanolol is chosen over other beta blockers in mgt of thyrotoxicosis?
Thanx
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Old 08-02-2012
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Propranolol - which has two roles in the treatment of hyperthyroidism, determined by the different isomers of propranolol.
L-propranolol causes beta-blockade, thus treating the symptoms associated with hyperthyroidism such as tremor, palpitations, anxiety, and heat intolerance.
D-propranolol inhibits Thyroxine deiodinase, thereby blocking the conversion of T4 to T3, providing some though minimal therapeutic effect.
Other beta blockers are used to treat only the symptoms associated with hyperthyroidism


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