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Department: DRUG CHALLENGE

Drugs to prevent migraines

Dalal, Kavitha S. PharmD; Bridgeman, Mary Barna PharmD, BCPS, BCGP

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doi: 10.1097/01.NURSE.0000659304.91749.69
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CAN YOU IDENTIFY these calcitonin gene-related peptide receptor antagonists used as preventive treatment for migraines in adults? To find out, match each brand name in Section I with its generic name in Section II.

Section I

______ 1. Ajovy (Teva)

______ 2. Aimovig (Amgen)

______ 3. Emgality (Eli Lilly)

Section II

a. fremanezumab-vfrm. Two subcutaneous options are available for administering the recommended dosage either monthly or every 3 months. The most common adverse reaction is injection site reaction. Teach patients the signs and symptoms of hypersensitivity reactions, including rash, pruritus, and urticaria, and explain that these can occur up to 1 month after administration. Safety and effectiveness in pediatric patients have not been established.

b. erenumab-aooe. This medication is administered subcutaneously via a prefilled autoinjector once monthly. Keep the autoinjector in the original carton to protect the drug from light and store in the refrigerator at 36°F to 46°F (2°C to 8°C). After removing the drug from the refrigerator, it can be kept at room temperature for up to 7 days. Discard any drug that has been left at room temperature for more than 7 days. Because the packaging may contain dry natural rubber, assess patients for latex sensitivity.

c. galcanezumab-gnlm. Besides the preventive treatment of migraine, this drug is also indicated for treatment of episodic cluster headaches. It is provided in single-dose prefilled pens and syringes to be administered subcutaneously in the abdomen, thigh, back of the upper arm, or buttocks. For migraine prophylaxis, patients receive an initial loading dose (administered as two consecutive injections), followed by monthly doses. Teach patients not to inject into skin that is tender, bruised, red, or hard. Before administration, they should allow the drug to sit at room temperature for 30 minutes.

Answers: 1a, 2b, 3c

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