True statement regarding migraine in pregnancy is:
Ans: (b) NSAIDs are first line drugsRef: Harrison's Principles of Internal Medicine, 19th edition, Page 2592Treatment of Acute MigraineNSAIDsNaproxen, lbuprofen,Tolfenamic acid Diclofenac, Acetominophen5-HT1 Receptor AgonistsOral: Ergotamine, Naratriptan, Rizatriptan, Sumatriptan, Frovatriptan, Almotriptan, Eletriptan, ZolmitriptanNasal: Sumatriptan, Zolmitriptan Parenteral: Dihydroergotamine, SumatriptanDopamine Receptor AntagonistsOral: Metoclopramide, ProchlorperazineParenteral: Chlorpromazine, Metoclopramide, ProchlorperazineOthersNasal: Butorphanol Parenteral: OpioidsMigraine During PregnancyImprovement in 'migraine without aura'Worsening of 'migraine with aura'Ergot derivatives are contraindicated due to possibility of uterine hypertonicity and vascular disruption leading on to miscarriageSafety of Triptans during pregnancy is not fully confirmed. Can be used only if other drugs are not effectiveTreatmentFirst line: NSAIDs and paracetamolTriptans are avoidedProphylaxis: Magnesium, Metoprolol
Ketorolac is preferred
NSAIDs are first line drugs
Improved symptoms with pregnancy
Sumatriptan preferred over chlorpromazine
Blood