Paper I
2018 February (2010 Scheme) · 40 marks · 120 min

Question

Sumatriptan

Q53 marksShort Notes

Answer

Sumatriptan is a selective 5-HT1B/1D receptor agonist (triptan) used for acute migraine attacks.

Mechanism of action

  • Stimulates 5-HT1B/1D receptors on intracranial (meningeal) blood vessels, causing vasoconstriction
  • Also inhibits release of vasoactive neuropeptides (e.g., CGRP) from trigeminal nerve terminals, reducing neurogenic inflammation

Uses

  • Acute treatment of migraine (with or without aura)
  • Cluster headache

Adverse effects

  • Chest tightness/pain (“triptan sensations”)
  • Tingling, flushing
  • Coronary vasospasm — contraindicated in ischaemic heart disease/uncontrolled hypertension
  • Should not be combined with ergotamine or MAO inhibitors (risk of prolonged vasospasm/serotonin syndrome)

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