Migraine: The Daily PANCE Blueprint

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Migraine: The Daily PANCE Blueprint

A 27-year-old has recurrent moderate-to-severe unilateral throbbing headaches with visual aura, nausea, and photophobia, and gets relief from sumatriptan. Sumatriptan aborts the attack primarily by acting as which of the following?

A. CGRP receptor antagonist
B. Dopamine (D2) receptor antagonist
C. Serotonin (5-HT1B/1D) receptor agonist
D. Cyclooxygenase (COX) inhibitor
E. Serotonin (5-HT2A) receptor antagonist

Answer and topic summary

The answer is C. Serotonin (5-HT1B/1D) receptor agonist.

Triptans such as sumatriptan are 5-HT1B/1D receptor agonists – they constrict dilated cranial vessels and inhibit release of calcitonin gene-related peptide (CGRP) from trigeminal nerve terminals. CGRP-receptor antagonists (‘gepants,’ such as ubrogepant) are a newer, separate abortive class; dopamine (D2) antagonists like metoclopramide are adjuncts for nausea; and COX inhibitors are the NSAIDs used for mild attacks.

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Covered under ⇒ PANCE Blueprint Neurology ⇒ Headaches ⇒ Migraine

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