RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016
Pharmacology
Easy
Drug used in the treatment of migraine is?
Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016
Explanation
- Ergotamine is an ergot alkaloid specifically used to abort acute migraine attacks.
- It functions as a partial agonist at 5-HT1B/1D serotonin receptors, which are prevalent in cranial blood vessels.
- This agonistic action causes vasoconstriction of the dilated arteries and inhibits neurogenic inflammation, thereby relieving migraine pain.
- It is most effective when taken at the very beginning of a migraine attack.
Why Other Options Were Wrong
- Option B: Histamine is a potent vasodilator and is implicated in causing headaches (histamine headache), not treating them. Administering histamine would likely worsen a migraine.
- Option C: Mephensin is a centrally acting muscle relaxant. Its mechanism of action is not related to the pathophysiology of migraine, which involves vascular and neuronal changes.
- Option D: Baclofen is a GABA-B receptor agonist used as a muscle relaxant and antispasmodic agent. It has no established role in treating acute migraines.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Pharmacological management of acute migraine helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses must screen patients for contraindications before administering ergotamine, including pregnancy, uncontrolled hypertension, coronary artery disease, and peripheral vascular disease, due to its potent vasoconstrictive effects.
- Patient education is crucial. Instruct patients to take ergotamine at the first sign of a migraine attack for maximum effectiveness and not to exceed the prescribed dosage to avoid toxicity.
- Monitor for and educate patients about the signs of ergotism (ergotamine toxicity), which include cold, numb, or tingling extremities, muscle pain, and chest pain. These symptoms require immediate medical attention.
How to Approach the Question
- First, identify the core of the question: it asks for a drug used to treat migraine.
- Scan the options and categorize them by their primary pharmacological class if known.
- Recall or deduce the primary use of each drug. Ergotamine is a classic, albeit older, medication specifically for migraine.
- Evaluate the distractors. Histamine is a known biological amine involved in allergies and vasodilation. Mephensin and Baclofen are muscle relaxants.
- Connect the pathophysiology of migraine (vasodilation of cranial arteries) with the mechanism of the drugs. Ergotamine's vasoconstrictive action directly opposes the pathology of a migraine headache.
- Select the option that has a clear, established therapeutic role in migraine management.
Concept Tested & Keywords
- Concept Tested: Pharmacological management of acute migraine
- Stem keywords: drug, treatment, migraine
- Lead-in keywords: is
- Negative lead-in flag: false
Question ID
QtjWGFRS9gHZFjgJYNkgC7
Reference Book
E6 Pharmacology KD Tripathi Essentials 9e Part 1 p. 215-217
E6 Pharmacology Katzung 16e p. 454-456
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 2133-2135
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