Mechanisms behind the drugs that are used in migraine nasal sprays
Triptans
Triptans [4] are one of the first-line treatments for migraine that’s moderate to severe in intensity. Your doctor may recommend a triptan if using NSAIDs or acetaminophen hasn’t been effective for easing acute migraine symptoms.
These drugs bind to certain subtypes of receptors in your brain that are specific for serotonin. Serotonin is a neurotransmitter whose levels are important in migraine.
When a triptan binds to these receptors, it allows the blood vessels in your brain to tighten (vasoconstriction). When this happens the pain and inflammation are reduced.
Ergotamines
Generally speaking, triptans have replaced ergotamines as one of the primary treatments of acute migraine attacks. Ergotamines are prescribed by your doctor if other medications are not yielding any results or not being effective at relieving symptoms.
Just like triptans, Ergotamines also bind to serotonin receptors in your brain. This causes blood vessels to constrict and lowers pain signaling. However, they are also less specific than triptans, which means that they can also cause more side effects.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs [5] inhibit an enzyme called cyclooxygenase (COX) 1 and 2, which blocks the production of prostaglandins. Prostaglandins are chemicals in the body that contribute to pain and inflammation.
Ketorolac, the type of NSAID that’s available as a nasal spray, can be prescribed to help with migraines that cause severe pain. It can also be used as rescue medication if the initial abortive medication prescribed is not effective.