Triptan Toxicity

11 Sep
Triptans are agonists at 5-HT1B and 5-HT1D receptors.
The 1B receptors cause  cerebral and systemic vasospasm.
 
The 1D neuronal receptors are presynaptic and inhibit release of inflammatory neuropeptides such as substance P.
 
The desired therapeutic effect is cephalic vasoconstriction, but adverse effects are related to systemic vasoconstriction, such as:
  • TIAs,
  • CVAs,
  • spinal cord infarction,
  • MI,
  • dysrhythmias,
  • renal infarction,
  • ischemic colitis.
 
Animal studies show the following symptoms at toxic doses:
–Tremor
–Erythema
–Paralysis
–Inactivity
–Salivation
–Lacrimation
–Seizures
 
Treatment may include GI decontamination, as well as vasodilating agents such as calcium channel blockers, IV nitroprusside or nitroglycerin, or phentolamine
 
Submitted by M. Smith.
 
References: Chu J, and Lewin NA. “Antimigraine Medications.” In Goldfrank’s Toxicologic Emergencies, 8th Edition. Flomenbaum et al, eds. McGraw-Hill, 2006.; picture
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One Response to “Triptan Toxicity”

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  1. triptans for cluster headaches | DAILYEM - September 17, 2013

    […] the synopsis article; the cochrane review; an old post on triptans; […]

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