drpkaur
Forum Guru
Topics: 195
Posts: 808
|
A 46-year-old woman presents with an acute migraine headache. She mentions that she also gets occasional chest pains at rest. Laboratory studies reveal an elevated serum total cholesterol. ECG shows ST segment depression with symmetric T wave inversion in some of the precordial leads. Which of the following antimigraine drugs would be contraindicated in this patient?
A. Ibuprofen
B. Methysergide
C. Nifedipine
D. Propranolol
E. Sumatriptan
|
| drfax
Forum Elite
Topics: 21
Posts: 233
|
D.propranolol
contraindicated in arrhythmia
___________________
My best friends are these Gentlemen :Why & How.
|
| fox
Forum Guru
Topics: 70
Posts: 727
|
Picture is that of Prinz metal Angina. I choose E. Sumatriptan. Here's the exlanation:
Therapeutic Categories
Serotonin 5-HT1D Receptor Agonist
Reasons not to take this medicine
If you have any of the following conditions: Ischemic heart disease, angina (chest pain or pressure coming from the heart), Prinzmetal's angina, heart attack, stroke, ischemic bowel disease, intermittent claudication, high blood pressure that is not controlled, certain types of migraines, severe liver disease.
___________________
Aim High
|
| Leopard
Forum Guru
Topics: 30
Posts: 401
|
Agreed with Fox
- Sumatriptan and Ergot alkaloids are contraindicated in CAD including Classical angina
- Propranolol is Contraindicated in PVD and Prinzmetal angina
___________________
FA is just a good revision book.It is not a "real" learning tool.
|
| Nan
Forum Senior
Topics: 12
Posts: 159
|
B. Methysergide. Side effects: Pleuropulmonary Fibrosis and Fibrotic Thickening of Cardiac Valves. . Depending on the vessel involved, this complication may present with chest pain, abdominal pain, or cold, numb, painful extremities.
|
| drpkaur
Forum Guru
Topics: 195
Posts: 808
|
answer is E. Sumatriptan is a 5HT1D partial agonist used to treat acute migraine. However, this drug can cause coronary artery spasm, and is contraindicated in patients with coronary artery disease or Prinzmetal angina, which this patient most likely has.
|
| Nan
Forum Senior
Topics: 12
Posts: 159
|
provocation testing for Prinzmetal's angina may involve substances such as ergonovine, methylergonovine or acetylcholine. Exaggerated spasm is diagnostic of Prinzmetal angina.
|
| goodyear
Forum Guru
Topics: 16
Posts: 409
|
Sumatriptan. C/I in pts' w/ CAD & prinzmetal angina.
|
|
| |
| | | | | | | | |
