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Old 08-01-2012
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Drug Sumatriptan Contraindication

A 33-year-old woman has been having left-sided pulsatile headaches for the past 8 months. The headaches are preceded by bilateral flashes of light and a sensation of light-headedness. Which of the following disorders would be a contraindication for prescribing sumatriptan for the treatment of this patient’s migraine headache?

a) Asthma
b) Coronary artery disease
c) Depression
d) Gastroesophageal reflux disease
e) Psychosis
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Old 08-01-2012
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B...risk of coronary vasospasm so CI in CAD
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Old 08-01-2012
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Quote:
Originally Posted by Casandra View Post
A 33-year-old woman has been having left-sided pulsatile headaches for the past 8 months. The headaches are preceded by bilateral flashes of light and a sensation of light-headedness. Which of the following disorders would be a contraindication for prescribing sumatriptan for the treatment of this patient’s migraine headache?

a) Asthma
b) Coronary artery disease
c) Depression
d) Gastroesophageal reflux disease
e) Psychosis

the answer is B
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Old 08-02-2012
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Correct Answer correct answer :)

The answer is b) Coronary artery disease

Sumatriptan can cause coronary vasospasm; therefore, it is contraindicated in patients with any type of coronary artery disease; this includes arteriosclerosis, ischemic cardiac disease, cerebrovascular and peripheral vascular diseases, and conditions of angina pectoris, vasospastic angina, acute myocardial infarction, history of myocardial infarction, silent myocardial ischemia, or Raynaud’s disease. The “triptans” are believed to mediate their beneficial effects in the treatment of migraine headaches by stimulating presynaptic 5-HT1D serotoninergic receptors, an action that inhibits both dural vasodilation and inflammation.
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Quote:
Originally Posted by Casandra View Post
The answer is b) Coronary artery disease

Sumatriptan can cause coronary vasospasm; therefore, it is contraindicated in patients with any type of coronary artery disease; this includes arteriosclerosis, ischemic cardiac disease, cerebrovascular and peripheral vascular diseases, and conditions of angina pectoris, vasospastic angina, acute myocardial infarction, history of myocardial infarction, silent myocardial ischemia, or Raynaud’s disease. The “triptans” are believed to mediate their beneficial effects in the treatment of migraine headaches by stimulating presynaptic 5-HT1D serotoninergic receptors, an action that inhibits both dural vasodilation and inflammation.
NB: by stimulating presynaptic 5-HT1B/1D serotoninergic receptors(agonist)
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