Professional and Linguistic Assessments Board (PLAB) Practice Exam

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Which alternative medication may be used for migraine prophylaxis in asthmatic patients?

Amitriptyline
Topiramate
Valproate
Gabapentin

The correct answer is: Topiramate

Topiramate is considered a suitable alternative medication for migraine prophylaxis in asthmatic patients. This is largely due to its favorable safety profile in individuals with respiratory conditions, as it does not have the respiratory effects that some other medications may have. Topiramate is an anticonvulsant that has been shown to significantly reduce the frequency of migraine attacks and can be particularly beneficial for patients who experience chronic migraines. In addition to its effectiveness in preventing migraines, it is generally well tolerated and has a lower risk of causing issues in patients with asthma compared to other options. When considering other medications listed, they either may not be as effective specifically for migraine prevention in asthmatic individuals or carry a higher risk of exacerbating respiratory conditions. Therefore, topiramate stands out as a reliable choice for migraine prophylaxis in this particular patient population.