Real Life Pharmacology Podcast - Sumatriptan Overview

Introduction

• Host: Pharmacist Eric Christensen
• Podcast: Real Life Pharmacology
• Resources: Download a free 31-page PDF at reallifepharmacology.com for a summary of top 200 drugs, clinical practice pearls, and board exam tips.
• Updates: Subscribe for new content and podcast updates.

Drug of the Day: Sumatriptan

• Brand Name: Imitrex
• Uses:
  • Primarily for acute migraine treatment.
  • Sometimes used for cluster headaches.

Mechanism

• Class: Triptan
• Mechanism: Serotonin agonist
  • Agonist at 5-HT 1B and 1D receptors.
  • Effects include vasoconstriction and reduction of inflammation.
  • Theories suggest these effects may help mitigate migraine symptoms.

Migraine Treatment

• First-Line Treatment: Simple analgesics (e.g., acetaminophen, NSAIDs) for mild cases.
• Triptan Use: Reserved for moderate to severe cases.

Usage Guidelines

• Dosage Limit: Avoid using more than 9 doses per month to prevent rebound headaches or medication overuse headaches.
• Dosing: 50 to 100 mg, repeatable after 2 hours if necessary (max 200 mg/day).
• Dosage Forms: Oral, nasal, subcutaneous (sub-Q).
  • Choice depends on patient preference and symptoms (e.g., nausea/vomiting).

Pharmacokinetics

• Onset of Action:
  • Oral: ~30 minutes
  • Nasal: 15-30 minutes
  • Sub-Q: ~10 minutes

Adverse Effects

• Vasoconstriction Risks:
  • Can lead to heart attacks or strokes.
  • Contraindicated in patients with cardiovascular risks (e.g., history of heart attack, stroke, TIA).
• QT Prolongation: Potential risk, especially in patients with existing risk factors.
• Other Side Effects: Dizziness, drowsiness, serotonin syndrome risk.
• Local Reactions: Possible with sub-Q and nasal forms.

Drug Interactions

• MAOIs: Rarely used but important to consider.
• Serotonergic Agents:
  • SSRI, SNRI, TCA, tramadol can increase serotonin syndrome risk.
  • Assess cumulative serotonin use in patients.

Conclusion

• Listener Engagement: Encourage ratings and reviews on iTunes.
• Support: Buy study materials at meded101.com/store to support the podcast.
• Contact: Questions and feedback can be directed to [email protected] or connect on LinkedIn.

• Host Outro: Thanks for listening, hope you have a great day!