Triptans migraine

The triptans are considered specific therapies in that they target the pathophysiology underlying migraine.33 They abort headache through beneficial effects on neuronal imbalances.11 Triptans inhibit neurotransmission in the trigeminal complex and activate serotonin lb/Id pathways that modulate nociception in the brain stem. They also decrease the release of vasoactive peptides leading to vascular reactivity and pain.34 Triptans are a welcome addition to the therapeutic armamentarium in that they are available in intranasal, subcutaneous, and oral... 

The P-blockers propranolol and timolol are FDA-approved for migraine prophylaxis, but other drugs in the class are also as effective.46 Cautious dosage titration is advised for those patients who do not have other indications for P-blocker use. Rizatriptan interacts with propranolol and thus dosages must be titrated downward, or another triptan chosen for abortive therapy.36 Comorbid reactive airway disease is a relative contraindication to P-blocker prophylaxis, and patients with cardiac conduction disturbances should be closely monitored. Calcium channel antagonists are often used when patients cannot tolerate P-blockers. They are purported to beneficially... 

Ferrari MD, Roon KI, Lipton RB, Goadsby PJ. Oral triptans (serotonin 5-HT1BAD agonists) in acute migraine treatment A meta-analysis of 53 trials. Lancet 2001 358 1558-1575. 

Ergot derivatives and triptans are specific treatments for migraine. Both are 5HTib/id serotonergic agonists. 

The adverse effects of the different members of the triptan class are quite similar, with the exception of chest oppression which is frequent with sumatriptan. Nausea, vomiting, fatigue, vertigo are frequently reported. Triptans are contraindicated (perhaps excessively) in aura migraine. 

Superiority over other triptan migraine headache agents has not been demonstrated... 

Considered alternative abortive acute migraine agent nasal spray less effective than triptans... 

Triptans and dihydroergotamine are drugs of choice for moderate to severe migraine attacks nasal sumatriptan is usually considered the triptan of choice due to its rapid onset there are a number of oral triptans, including frovatriptan, with more favorable biopharmaceuticprofiles and high costs comparisons not available... 

Pascual J, et al Marketed oral triptans in the acute treatment of migraine A systematic review on efficacy and tolerability. Headache 2007 47 1152. [PMID 17883520]... 

The most recent treatment for migraine is a class of compounds known as the "triptans" - sumatriptan and its progeny. These seem to be about 65% effective and show fewer side effects. 

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