1,721,181 research outputs found
Pharmacokinetics of indomethacin in chronic migraine patients after withdrawal of the overused combination of indomethacin, prochlorperazine, and caffeine
No full textThe combination of indomethacin, prochlorperazine and caffeine (IPC) is often overused by migraine patients who develop medication-overuse headache (MOH), a secondary chronic headache that resolves after withdrawal of the overused medication. In a previous study (1) we showed that indomethacin clearance was lower in chronic migraine patients overusing IPC combination than in migraine patients only occasionally taking this combination. Objective: To verify if the reduced clearance of indomethacin reverts to normal after withdrawal of the overused IPC. Methods: We repeated the study of indomethacin pharmacokinetics in 9 female headache patients after 6 months from inpatient withdrawal of the IPC combination. In each patients indomethacin pharmacokinetics had been already studied before withdrawal treatment. The IPC combination (indomethacin 50 mg, prochlorperazine 8 mg, caffeine150 mg) habitually taken was administered by rectal route to each patient. Blood samples were drawn before dosing and at the following post-dose times: 0.5, 1, 2, 3, 4, and 6 h. Indomethacin concentrations were measured by HPLC method. Pharmacokinetic parameters were calculated by means of the P K Solutions 2.0 program. Results: The pharmacokinetic parameters of indomethacin in 4 patients (group A) who relapsed in IPC overuse were similar to those observed before withdrawal treatment; instead (Table 1) in 5 patients (group B) who steadily discontinued IPC combination, indomethacin disposition was significantly different from that observed before withdrawal treatment. Table 1. Pharmacokinetic parameters of indomethacin in group B. Parameter Before withdrawal After withdrawalHalf life (h) 2.74+0.98 1.45+0.34 *AUC0-t (mg/h/ml) 13.02+6.62 5.36+2.36 *Cl (ml/h/Kg) 64.05+30.16 123.98+39.91 *
*P <0.05 (paired Student’ t-test)Conclusions: In headache patients who discontinued IPC overuse, indomethacin clearance increased and reverted to values previously obtained in occasional IPC users (1).1. Ferrari A., Savino G., Gallesi D., Pinetti D., Bertolini A., Sances G., et al. (2006) Pharmacol Res. 542: 142-149
Andamento dell’emicrania durante la gravidanza e il puerperio. Revisione della letteratura e risultati di uno studio prospettico
No full text
Il paziente cefalalgico: gestione ed aspetti socio-economici.
No full textI costi economici per il SSN per la gestione ambulatoriale ed in regime di ricovero di pazienti con emicrania, ed aspetti critici del sistema a DR
RITANSERIN IN MENSTRUAL MIGRAINE AND PREMENSTRUAL COMPLAINTS PROPHYLAXIS
No full textRITANSERIN IN MENSTRUAL MIGRAINE AND PREMENSTRUAL COMPLAINTS PROPHYLAXI
Lessons from placebo effects in migraine treatment.
Full text linkIn medical research, the placebo effect is an important methodological tool. Placebo is given to participants in clinical trials, with the intention of mimicking an experimental intervention. The "nocebo" effect, on the other hand, is the phenomenon whereby a patient who believes that a treatment will cause harm actually does experience adverse effects. The placebo effect strongly influences the way the results of clinical trials are interpreted. Placebo responses vary with the choice of study design, the choice of primary outcome measure, the characteristics of the patients and the cultural setting in which the trial is conducted. In migraine trials, the placebo response is high, in terms of both efficacy and side effects. Although medical ethics committees are becoming increasingly resistant to the use of placebo in acute migraine trials, placebo nevertheless remains the pivotal comparator in trials of migraine medications
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