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What Are the Acute Treatments for Migraine and How Are They Used?
2. Acute Treatment CQ II-2-1 What are the acute treatments for migraine and how are they used? Recommendation The mainstay of acute treatment for migraine is pharmacotherapy. The drugs used include (1) acetaminophen, (2) non-steroidal anti-inflammatory drugs (NSAIDs), (3) ergotamines, (4) triptans and (5) antiemetics. Stratified treatment according to the severity of migraine is recommended: use NSAIDs such as aspirin and naproxen for mild to moderate headache, and use triptans for moderate to severe headache, or even mild to moderate headache when NSAIDs were ineffective in the past. It is necessary to give guidance and cautions to patients having acute attacks, and explain the methods of using medications (timing, dose, frequency of use) and medication use during pregnancy and breast-feeding. Grade A Background and Objective The objective of acute treatment is to resolve the migraine attack completely and rapidly and restore the patient’s normal functions. An ideal treatment should have the following characteristics: (1) resolves pain and associated symptoms rapidly; (2) is consistently effective; (3) no recurrence; (4) no need for additional use of medication; (5) no adverse effects; (6) can be administered by the patients themselves; and (7) low cost. Literature was searched to identify acute treatments that satisfy the above conditions. Comments and Evidence The acute treatment drugs for migraine generally include (1) acetaminophens, (2) non-steroidal anti-inflammatory drugs (NSAIDs), (3) ergotamines, (4) triptans, and (5) antiemetics. For severe migraines including status migrainosus and migraine attacks refractory to treatment, (6) anesthetics, and (7) corticosteroids (dexamethasone) are used (Tables 1 and 2).1)-9) There are two approaches to the selection and sequencing of these medications: “step care” and “stratified care”. -
Menstrually Related and Nonmenstrual Migraines in A
MENSTRUALLY RELATED AND NONMENSTRUAL MIGRAINES IN A FREQUENT MIGRAINE POPULATION: FEATURES, CORRELATES, AND ACUTE TREATMENT DIFFERENCES A dissertation presented to the faculty of the College of Arts and Sciences of Ohio University In partial fulfillment of the requirements for the degree Doctor of Philosophy Brenda F. Pinkerman March 2006 This dissertation entitled MENSTRUALLY RELATED AND NONMENSTRUAL MIGRAINES IN A FREQUENT MIGRAINE POPULATION: FEATURES, CORRELATES, AND ACUTE TREATMENT DIFFERENCES by BRENDA F. PINKERMAN has been approved for the Department of Psychology and the College of Arts and Sciences by Kenneth A. Holroyd Distinguished Professor of Psychology Benjamin M. Ogles Interim Dean, College of Arts and Sciences PINKERMAN, BRENDA F. Ph.D. March 2006. Clinical Psychology Menstrually Related and Nonmenstrual Migraines in a Frequent Migraine Population: Features, Correlates, and Acute Treatment Differences (307 pp.) Director of Dissertation: Kenneth A. Holroyd This research describes and compares menstrually related migraines as defined by recent proposed guidelines of the International Headache Society (IHS, 2004) to nonmenstrual migraines in a population of female migraineurs with frequent, disabling migraines. Migraines are compared by frequency per day of the menstrual cycle, headache features, use of abortive and rescue medications, and acute migraine treatment outcomes. In addition, this study explores predictors of acute treatment response and headache recurrence within 24 hours following acute migraine treatment for menstrually related migraines. Participants are 107 menstruating female migaineurs who met IHS (2004) proposed criteria for menstrually related migraines and completed headache diaries using hand-held computers. Diary data are analyzed using repeated measures logistic regression. The frequency of migraines is significantly increased during the perimenstrual period, and menstrually related migraines are of longer duration and greater frequency with longer lasting disability than nonmenstrual migraines. -
Use of Analgesics in Exotic Felids Edward C. Ramsay, DVM Professor, Department of Small Animal Clinical Sciences, University Of
Use of Analgesics in Exotic Felids Formatted: Centered Edward C. Ramsay, DVM Professor, Department of Small Animal Clinical Sciences, University of Tennessee, and Consulting Veterinarian, Knoxville Zoological Gardens, Knoxville, Tennessee. Corresponding address: Ed Ramsay Dept. of Sm Animal Clin Sci C247, Veterinary Teaching Hospital University of Tennessee Knoxville, TN 37996-4544 Phone: 865-755-8219 FAX: 865-974-5554 Email: [email protected] 2 Treatment of pain in domestic and non-domestic cats has been a challenge for the clinician. Many cat species are stoic and show few or very subtle external signs of pain. Additionally, the adverse effects of nonsteroidal antiinflammatory drugs (NSAIDs) in domestic cats are well documented and have discouraged many practitioners from trying novel NSAID’s in exotic felids. As in other animals, each cat’s response to pain and analgesics will vary, necessitating an individualized treatment plan. As a rule, always treat painful felids to effect, and not by rote reliance on published dosages. It is frequently necessary to try different agents and combinations to find which produces the optimal analgesic effect in exotic felids. In order to minimize adverse effects, it is desirable to work toward treatment with the lowest effective dose when treating chronic pain. Non-steroidal Antiinflammatory Drugs NSAIDs are antiinflammatory drugs which act both centrally and peripherally. The primary effects are believed to be caused by their ability to inhibit cyclooxygenase (COX) enzymes in the arachidonic acid metabolism cascade. The COX-1 isoform is regarded as constitutive (continuously expressed) and is responsible for many homeostatic processes, such as maintenance of gastric mucosal integrity, platelet function, and renal autoregulation. -
Non-Steroidal Anti-Inflammatory Drugs Inhibit Bone Healing: a Review S
Review Article © Schattauer 2010 385 Non-steroidal anti-inflammatory drugs inhibit bone healing: A review S. Barry Washington State University, Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, Pullman, Wash- ington, USA crine and autocrine activity, have since Keywords stems from prostaglandin inhibition and is been shown to regulate constitutive and in- Non-steroidal anti-inflammatory drugs, likely multifactorial. In human medicine ducible functions throughout the body, in- NSAID, bone healing NSAID are known to prevent heterotopic ossi- cluding bone healing (5–9). The mech- fication, however the clinical importance of anism of NSAID inhibition to bone healing Summary their effects on bone healing remains contro- is unknown, but is likely multifactorial. Re- The ability of non-steroidal anti-inflammatory versial. Although a small handful of reports searchers have suggested that NSAID affect drugs (NSAID) to inhibit bone healing has suggest that NSAID suppress bone healing in normal bone healing in multiple ways, with been established in experimental animal dogs and horses, there is little published infor- emphasis often (but not exclusively) placed models using mice, rats, and rabbits. The mation to direct veterinary practice in do- on processes related to the inflammatory mechanism of action is largely unknown but mestic species. stage. Deciphering the mechanism of NSAID inhibition requires an understanding of Correspondence to: Vet Comp Orthop Traumatol 2010; 23: 385–392 Sabrina Barry, DVM doi:10.3415/VCOT-10-01-0017 fracture healing. Fracture healing presents Washington State University Received: January 31, 2010 an exquisitely orchestrated series of coor- Department of Veterinary Clinical Sciences Accepted: June 23, 2010 dinated molecular and cellular events. -
Latest Administration Hour Prior to Competition Max Dosage Per Pound of Body Weight Medication Trade Name Medication Generic Name
MEDICATION MEDICATION MAX DOSAGE PER POUND LATEST ADMINISTRATION HOUR ADMINISTRATION METHOD GENERIC NAME TRADE NAME OF BODY WEIGHT PRIOR TO COMPETITION (single dose per 24 hours unless specified otherwise) Dexamethasone Azium® 2.0 mg/100Lb >12 hours IV, IM (20 mg/1000Lb) or 0.5 mg/100Lb >6 hours IV (5.0 mg/1000Lb) or 1.0 mg/100LB >6 hours Oral (10 mg/1000Lb) Diclofenac Surpass® 5 inch ribbon, 1⁄2 inch thick, >12 hours Topical, 2 doses each day 12 hours apart one site Firocoxib Equioxx® 0.1 mg/kg >12 hours Oral (0.0455 mg/Lb) (45.5 mg/1000Lb) Phenylbutazone (“bute”) * Butazolidin® 2.0 mg/Lb >12 hours Oral, IV (2.0 grams/1000Lb) or 1.0 mg/Lb AM & PM feed Oral, 2 doses each day, 12 hours apart (1.0 grams/1000Lb) Flunixin meglumine * Banamine® 0.5 mg/Lb >12 hours Oral, IV (500 mg/1000Lb) Ketoprofen Ketofen® 1.0 mg/Lb >4 hours, but IV (1.0 gram/1000Lb) >6 hours is recommended Meclofenamic acid Arquel® 0.5 mg/Lb Oral, 2 doses each day, 12 hours apart (500 mg/1000Lb) Naproxen Naprosyn® 4.0 mg/Lb >12 hours Oral (4.0 grams/1000Lb) Eltenac Not yet approved Telzenac® 0.25 mg/Lb (250 mg/1000Lb) 12 hours IV Methocarbamol Robaxin® 5.0 mg/Lb >6 hours Oral, IV, 2 doses each day, 12 hours apart (5.0 grams/1000Lb) * Do not administer phenylbutazone and flunixin at the same time (Unless used according to The maximum treatment time for any of the above permitted medication is five days, with the Section 8). -
Simultaneous Determination of Residues of Non-Steroidal Anti-Inflammatory Drugs and Glucocorticosteroids in Animal Muscle By
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Springer - Publisher Connector Food Anal. Methods (2016) 9:1837–1848 DOI 10.1007/s12161-015-0352-y Simultaneous Determination of Residues of Non-Steroidal Anti-Inflammatory Drugs and Glucocorticosteroids in Animal Muscle by Liquid Chromatography-Tandem Mass Spectrometry Piotr Jedziniak1 & Małgorzata Olejnik1 & Konrad Pietruk1 & Edyta Protasiuk1 & Teresa Szprengier-Juszkiewicz1 & Jan Żmudzki1 Received: 11 February 2015 /Accepted: 4 November 2015 /Published online: 21 November 2015 # The Author(s) 2015. This article is published with open access at Springerlink.com Abstract A method for the determination of a wide range Introduction residues of anti-inflammatory drugs (16 acidic non-steroidal anti-inflammatory drugs and four metamizole metabolites and Non-steroidal anti-inflammatory drugs (NSAIDs) and five corticosteroids) has been was developed. In the first step glucocorticosteroids (GCs) are widely used in veterinary medi- of sample preparation, acetate buffer was added to minced cine as well as in treatment of diseases in food-producing ani- muscle samples and 15-min ultrasound-assisted enzymatic mals. Despite its effectiveness, the important drawback of phar- hydrolysis was performed. Next, the samples were extracted macotherapy is drug residues in animal tissues. It became an twice with acetonitrile, freezed and analysed. The analytes important issue in the food safety. Potential toxicity of medicinal were separated on a C18 column with a 25-min gradient of veterinary products has to be evaluated before the drug registra- methanol/acetonitrile (8:2) and 0.05 M ammonium formate at tion. When necessary, maximum residue limits (MRLs) in food pH 5.0 and determined by liquid chromatography-tandem are established. -
Acute Migraine Treatment
Acute Migraine Treatment Morris Levin, MD Professor of Neurology Director, Headache Center UCSF Department of Neurology San Francisco, CA Mo Levin Disclosures Consulting Royalties Allergan Oxford University Press Supernus Anadem Press Amgen Castle Connolly Med. Publishing Lilly Wiley Blackwell Mo Levin Disclosures Off label uses of medication DHE Antiemetics Zolmitriptan Learning Objectives At the end of the program attendees will be able to 1. List all important options in the acute treatment of migraine 2. Discuss the evidence and guidelines supporting the major migraine acute treatment options 3. Describe potential adverse effects and medication- medication interactions in acute migraine pharmacological treatment Case 27 y/o woman has suffered ever since she can remember from “sick headaches” . Pain is frontal, increases over time and is generally accompanied by nausea and vomiting. She feels depressed. The headache lasts the rest of the day but after sleeping through the night she awakens asymptomatic 1. Diagnosis 2. Severe Headache relief Diagnosis: What do we need to beware of? • Misdiagnosis of primary headache • Secondary causes of headache Red Flags in HA New (recent onset or change in pattern) Effort or Positional Later onset than usual (middle age or later) Meningismus, Febrile AIDS, Cancer or other known Systemic illness - Neurological or psych symptoms or signs Basic principles of Acute Therapy of Headaches • Diagnose properly, including comorbid conditions • Stratify therapy rather than treat in steps • Treat early -
Non-Steroidal Anti-Inflammatory Drugs As Chemopreventive Agents: Evidence from Cancer Treatment in Domestic Animals
Annual Research & Review in Biology 26(1): 1-13, 2018; Article no.ARRB.40829 ISSN: 2347-565X, NLM ID: 101632869 Non-Steroidal Anti-Inflammatory Drugs as Chemopreventive Agents: Evidence from Cancer Treatment in Domestic Animals Bianca F. Bishop1 and Suong N. T. Ngo1* 1School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA 5371, Australia. Authors’ contributions This work was carried out in collaboration between both authors. Author BFB performed the collection and analysis of the data. Author SNTN designed the study, managed the analyses and interpretation of the data and prepared the manuscript. Both authors read and approved the final manuscript. Article Information DOI: 10.9734/ARRB/2018/40829 Editor(s): (1) David E. Martin, Martin Pharma Consulting, LLC, Shawnee, OK, USA. (2) George Perry, Dean and Professor of Biology, University of Texas at San Antonio, USA. Reviewers: (1) Fulya Ustun Alkan, Istanbul University, Turkey. (2) Thompson Akinbolaji, USA. (3) Ramesh Gurunathan, Sunway Medical Center, Malaysia. (4) Mohamed Ahmed Mohamed Nagy Mohamed, El Minia Hospital, Egypt. Complete Peer review History: http://www.sciencedomain.org/review-history/24385 Received 10th February 2018 Accepted 21st April 2018 Review Article Published 30th April 2018 ABSTRACT Aims: This study aims to systematically review currently available data on the use of non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of cancer in domestic animals to evaluate the efficacy of different treatment protocols and to suggest further recommendations for future study. Methodology: Literature data on the use of NSAIDs in domestic animals as chemo-preventive agents in the last decade were collected and critically reviewed. -
Transitional Cell Carcinoma: Options Beyond Nsaids Julie Marie Gillem, DVM, DACVIM (Oncology) Overview
Transitional Cell Carcinoma: Options Beyond NSAIDs Julie Marie Gillem, DVM, DACVIM (Oncology) Overview ✦ Background ✦ Surgical Options ✦ Pathology ✦ Medical Options ✦ Location and staging ✦ Radiation Therapy ✦ Behavior Options ✦ Etiology and risk factors ✦ Palliative care ✦ Work up and diagnosis ✦ What about cats? Objectives ✦ How do we determine when NSAIDs fail? ✦ When should we intervene with surgery, chemotherapy, radiation therapy, and additional palliative care? Pathology ✦ ~2% of canine cancer ✦ Invasive transitional cell carcinoma (TCC) most common ✦ Others: SCC, adenocarcinoma, undifferentiated carcinoma, rhabdomyosarcoma, fibroma, and other mesenchymal tumors Location and Staging ✦ TCC in dogs most often found in the trigone of the bladder ✦ Series of 102 dogs at PUVTH ✦ Urethra and bladder in 56% ✦ Prostate involvement in 29% male dogs ✦ Lymph node mets in 16% at diagnosis ✦ Distant mets in 14% at diagnosis ✦ Distant mets in 50% at death Location ✦ TCC in dogs most often is found in the trigone region of the bladder. ✦ In a series of dogs with TCC examined at the PUVTH, the tumor involved the urethra as well as the bladder in 57 of 102 dogs (56%), and it involved the prostate in 11 of 38 (29%) male dogs. WHO Staging ✦ 78% T2 tumors ✦ 20% T3 tumors Biological Behavior ✦ At diagnosis: ✦ Regional lymph node metastasis in 12-46 % (Norris et al 1992, Knapp et al 2000, Blackburn et al 2013) ✦ Distant metastasis in 16- 23% (Norris et al 1992, Blackburn et al 2013) ✦ Distant metastasis in 50% at death (Norris et al 1992, Knapp et al -
Supplementary Material Exploring the Efficiency of UHPLC-Orbitrap MS For
Supplementary Material Exploring the efficiency of UHPLC-Orbitrap MS for the determination of 20 pharmaceuticals and acesulfame K in hospital and urban wastewaters with the aid of FPSE Maria Kalaboka, Christoforos Chrimatopoulos, Cristina Jiménez-Holgado, Vasiliki Boti, Vasilios Sakkas, * and Triantafyllos Albanis University of Ioannina, Chemistry Department, 45110 Ioannina, Greece; [email protected], [email protected] , [email protected], [email protected], talbanis@uoi,gr, [email protected] * Correspondence: [email protected]; Tel.: +30-2651008303 Table S1: Physicochemical properties and chemical structures of target analytes Molecular Therapeutic Compound Chemical Structure pKa [Ref.] logP Formula class - Artificial Acesulfame C4H5NO4S 2.0 [1] 0.552 Sweetener tricyclic Amitriptiline C20H23N 9.4 [2] 4.81 antidepressant s Psychiatric Carbamazepine C15H12N2O 7.0/13.9 [3] 2.766 Antiepileptic Drugs Psychiatric Clomipramine C19H23ClN2 8.98 [4] 4.883 Antidepressant Drugs Psychiatric Cyclobenzaprine C20H21N 8.47 [5] 4.613 Antidepressant Drugs Non-steroidal anti- Diclofenac C14H11Cl2NO2 4.2 [3] 4.259 inflammatory drug (NSAID) Macrolide Erythromycin C37H66NO12 8.9 [3] 2.596 Antibiotic Antidepressant Fluoxetine C17H18F3NO 10.1 [6] 4.173 Drugs Analgesic-anti- Indomethacin C19H16ClNO4 4.27 [3] 3.53 inflammatory drug Nonsteroidal anti- Mefenamic Acid C15H15NO2 4.2 [7] 5.398 inflammatory drugs (NSAID) Psychiatric Paroxetine C19H20O3NF 9.6 [6] 3.148 Antidepressant Drugs Non-steroidal anti- Salicylic acid C7H6O3 2.3/3.5 [6] 1.977 inflammatory drug (NSAID) Sulfonamide Sulfacetamide C8H10N2O3S 5.4 [8] -0.3 Antibiotic Sulfonamide Sulfamethazine C12H14N4O2S 7.6/2.65 [9] 0.65 Antibiotic Sulfonamide Sulfamethoxazole C10H11N3O3S 5.7/1.6 [9] 0.791 Antibiotic Sulfamethoxy- Sulfonamide C11H12N4O3S 6.7 [9] 0.466 pyridazine Antibiotic 6.24/2. -
(12) United States Patent (10) Patent No.: US 6,221,377 B1 Meyer (45) Date of Patent: Apr
USOO6221377B1 (12) United States Patent (10) Patent No.: US 6,221,377 B1 Meyer (45) Date of Patent: Apr. 24, 2001 (54) ADMINISTRATION MEDIA FOR (56) References Cited ANALGESIC, ANTI-INFLAMMATORY AND ANT-PYRETC DRUGS CONTAINING FOREIGN PATENT DOCUMENTS NITROUS OXDE AND PHARMACEUTICAL 2 277 264 10/1994 (GB). COMPOSITIONS CONTAINING SUCH MEDIA AND DRUGS OTHER PUBLICATIONS (75) Inventor: Petrus Johannes Meyer, Randburg Chemical ABstracts AN 1985:464783, Hertz et al., Jan. (ZA) 1985.* Chemical Abstracts AN 1978:44978, Berkowitz et al., Jan. (73) Assignee: Pitmy International N.V., Bonaire 1977.* (NL) International Publication No. WO93/25213, published Dec. 23, 1993. (*) Notice: Subject to any disclaimer, the term of this Mikrochim. Acta, vol. 2, No. 5-6, 1980 pp. 464–474, Stahl patent is extended or adjusted under 35 et al., Extraction of natural Substances using Supercritical U.S.C. 154(b) by 0 days. and liquified gases. (21) Appl. No.: 09/068,543 Reynolds J.E.F. et al., “Martindale', 1989, The Pharmaceu tical Press. (22) PCT Filed: Nov. 13, 1996 Science, vol. 194, No. 4268, 1976, pp. 967–968, Berkowitz (86) PCT No.: PCT/IB96/01366 et al., "Nitrous oxide “analgesia': resemblance to opiate action'. S371 Date: May 13, 1998 Steinegger et al., “Lehrbuch der Pharmakognosie und Phy S 102(e) Date: May 13, 1998 topharmazie', Edition 4, 1988. (87) PCT Pub. No.: WO97/17978 * cited by examiner PCT Pub. Date: May 22, 1997 Primary Examiner Jyothsna Venkat (30) Foreign Application Priority Data ASSistant Examiner-Grace Hsu (74) Attorney, Agent, or Firm-Arent Fox Kintner Plotkin Nov. 13, 1995 (ZA) ................................................... -
Celecoxib Prevents Doxorubicin-Induced Multidrug Resistance in Canine and Mouse Lymphoma Cell Lines
cancers Article Celecoxib Prevents Doxorubicin-Induced Multidrug Resistance in Canine and Mouse Lymphoma Cell Lines Edina Karai 1,2 , Kornélia Szebényi 1,3,Tímea Windt 1 ,Sára Fehér 2, Eszter Szendi 2, Valéria Dékay 2,Péter Vajdovich 2, Gergely Szakács 1,3,* and András Füredi 1,3,* 1 Institute of Enzymology, Research Centre of Natural Sciences, Eötvös Loránd Research Network, Magyar Tudósok körútja 2, H-1117 Budapest, Hungary; [email protected] (E.K.); [email protected] (K.S.); [email protected] (T.W.) 2 Department of Clinical Pathology and Oncology, University of Veterinary Medicine Budapest, István utca 2, H-1078 Budapest, Hungary; [email protected] (S.F.); [email protected] (E.S.); [email protected] (V.D.); [email protected] (P.V.) 3 Institute of Cancer Research, Medical University of Vienna, Borschkegasse 8A, A-1090 Vienna, Austria * Correspondence: [email protected] (G.S.); [email protected] (A.F.) Received: 1 April 2020; Accepted: 24 April 2020; Published: 29 April 2020 Abstract: Background: Treatment of malignancies is still a major challenge in human and canine cancer, mostly due to the emergence of multidrug resistance (MDR). One of the main contributors of MDR is the overexpression P-glycoprotein (Pgp), which recognizes and extrudes various chemotherapeutics from cancer cells. Methods: To study mechanisms underlying the development of drug resistance, we established an in vitro treatment protocol to rapidly induce Pgp-mediated MDR in cancer cells. Based on a clinical observation showing that a 33-day-long, unplanned drug holiday can reverse the MDR phenotype of a canine diffuse large B-cell lymphoma patient, our aim was to use the established assay to prevent the emergence of drug resistance in the early stages of treatment.