<prompt> True statement regarding migraine in pregnancy is:Ketorolac is preferredNSAIDs are first line drugsImproved symptoms with pregnancySumatriptan preferred over chlorpromazine  <response>: Ans: b NSAIDs are first line drugsRef: Harrisons 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 auraWorsening of migraine with auraErgot 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 