DOCSLIB.ORG

2Nd European Headache and Migraine Trust INTERNATIONAL CONGRESS - EHMTIC

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
2Nd European Headache and Migraine Trust INTERNATIONAL CONGRESS - EHMTIC 2nd European Headache and Migraine Trust INTERNATIONAL CONGRESS - EHMTIC Nice, France October 28–31, 2010 ABSTRACT BOOK Co-Chairmen H-C. Diener, Germany P.J. Goadsby, UK International Scientific Advisory Committee F. Antonaci, Italy A. Charles, USA M. Ferrari, The Netherlands R. Jensen, Denmark Z. Katsarava, Germany M. Lanteri-Minet, France R. Lipton, USA J. Pascual, Spain J. Schoenen, Belgium S. Silberstein, USA D. Valade, France M.M. Wysocka-Bakowska, Poland 123 J Headache Pain (2010) 11 (Suppl 1):S1–S150 DOI 10.1007/s10194-010-0259-3 10 over between groups was realized. The frequency and the intensity of Outcome of vitamin C supplementation on lead-induced headache as well as the amount of drug intake were registered on a standardized diary from three months before the implant until the end of apoptosis in adult rat hippocampus follow-up. Quality of life was measured using a dedicated scale (SF_36 e MIDAS) at -3 0-1-3-6-12 months follow-up.34 patients have been 1 2 3 M. Mehdizade , F. Kermanian , I. Nourmohamadi enrolled in this study.After 1 year follow-up our results demonstrate a significant reduction in headache frequency (56%) and intensity (from 1Department of Anatomical Sciences, Iran University of Medical 7.8 to 5.8 in Visual analogic scale): drugs intake reduced (): media from Sciences, Molecular and Research Center, Tehran, Iran; 45 to 11 intakes for month) till then MOH changed in original primary 2Department of Anatomical Sciences, Mashhad University of Medical headache (100% migraine without aura (1.1 ICHD-II).; chronic Sciences, Mashhad, Iran; migraine (1.5.1 ICHD-II) became too migraine without aura (1.1 ICHD- 3Department of Biochemistry, Iran University of Medical Sciences, II). Adverse events were light and completely reversible. Tehran, Iran Background Lead (Pb), due to its numerous industrial applications has caused widespread pollution of the environment. One principle 17 target for lead in the human body is the central nervous system (CNS). Wolff’s extracranial vascular theory of migraine: Research has shown however that the toxic effects of lead can be moderated by antioxidant agents such as vitamin C. a great story confirmed by the facts Objective To investigate the protective effects of vitamin C supple- mentation against lead induced apoptosis in the adult male rat E. Shevel hippocampus. Design, time and setting Animal experiment, including light and The Headache Clinic, Johannesburg, South Africa electron microscopic staining and western blot analysis, was per- formed in the College of Medicine, Iran University between Objectives To clarify the role of extracranial vasodilatation in December 2007 and April 2009. migraine, and to expose the distortions and misrepresentations in the Materials Lead (Pb) was used for toxication and Vit C was use as an literature concerning this subject. antioxidant drug and Bax and Bcl-2 were used as primary antibodies. Background There has over the years been a considerable amount of Methods Animals were divided into three groups; control, Lead controversy over whether the vascular component of migraine pain treated, Lead + Vit C-treated group) rats. They treated for 7 days. arises from the intracranial or the extracranial vessels, or both. Some Main outcome measure At the end of treatment, blood Lead level have even questioned whether vasodilatation actually plays a signif- was measured. Neuronal death was determined using light and elec- icant role in migraine pain, and have described it as an unimportant tron microscopic staining and western blot analysis epiphenomenon. The controversy is an artificial one though, which Results Lead + Vit C treatment reduced neuronal apoptosis com- has been generated as a consequence of misrepresentation of the facts pared to Lead treated rats. There were decrease of Bax expression in in the headache literature. the hippocampus of Lead + Vit C group compared to Lead group in Methods The literature on the subject is extensively researched for western blotting. Changes in blood Lead level was not significant in verifiable hard scientific data on the subject. three groups. Results There have been blatant distortions in the literature with Conclusion The results suggest that supplementing essential nutrient regard to the role of extracranial vasodilatation in migraine. There is a vitamin C may prevent lead-induced apoptosis. plethora of hard scientific evidence to show that extracranial vaso- dilatation is important in migraine. Conclusions There have been significant distortions and misrepre- sentations in the literature, which have led many headache specialist 15 to believe, erroneously, that extracranial vasodilatation is not Suboccipital neurostimulation in chronic headache: important in migraine. The hard scientific evidence shows that a prospective, randomized with cross over study (i) vasodilatation is indeed a source of pain in migraine, (ii) that this dilatation does not involve the intracranial vasculature, F. Marchioretto1, G. Serra2 (iii) that the extracranial terminal branches of the external carotid artery are a source of pain in migraine. 1Headache Center, Negrar, Italy; 2Anthalgic Therapy Service, Ospedale Sacro Cuore, Negrar, Italy Patients affected by chronic headache experience a significant reduc- 20 tion in quality of life. No effective treatments are today available for this Endothelium dependent vasodilatation in migraine condition We performed a prospective, randomized study to evaluate patients safety and efficacy of bilateral suboccipital neurostimulation in patients with chronic migraine (CM) and medication overuse headache (MOH). Patients with CM and MOH were enrolled in a single Hospital headache D. Perko, M. Zaletel, B. Zvan, J. Pretnar-Oblak Center by a neurologist with experience in headache. In a preliminary phase, after signed informed consent, stimulators (Medtronic Synergy Vascular Neurology, University Clinical Centre Ljubljana, Versitrel) were provisionally implanted as an external device. After Ljubljana, Slovenia 30 days, if attack frequency was reduced C50%, neurostimulator was subcutaneously implanted. Patients were randomized into treatment Although endothelial dysfunction might be an important feature (ON stimulator) or control (OFF stimulator) groups. At week 4 cross- involved in the pathophysiology of migraine, it has been 123 J Headache Pain (2010) 11 (Suppl 1):S1–S150 S3 investigated only in a few studies. The obtained conflicting results play an important role as a causative factor. Gabapentin and Local did not provide definitive answer on the presence of endothelial injection of trigger points with corticosteroids are noted to be effec- dysfunction in migraine patients. We sought to explore flow-medi- tive in prophylactic treatment of (CTTH). ated dilatation (FMD) in migraine patients. By employing strict Materials and methods We selected CTTH patients who had active inclusion criteria we avoided the possible changes of FMD by trigger point in the head and divided them in two groups of De- confounding factors, that could produce previously obtained con- pomedrol and Gabapentin. Depomedrol was injected 10 mg per each flicting results. Forty-two patients with migraine (female 34, male 8) TrPt up to total dose of 40 mg in each patient. Gabapentin was and twenty-one healthy subjects matched by gender and age were initiated with 200 mg/day and gradually increased to 300-600 mg included. All patients had normal values of intima-media thickness daily. of carotid arteries and did not have diseases known to affect Results Headache Intensity 9 Duration index showed marked endothelial function. FMD of brachial arteries were measured by decrease in both groups. It was significantly lower in Depomedrol using standard procedure. We did not find any difference in FMD receiving patients at the end of first (368.13 ± 195.75 Vs between patients with migraine and healthy subjects (p = 0.78). 467.73 ± 203.09, P \ 0.05) and second months (165.44 ± 62.75Vs Also no differences were found between group of healthy subjects, 238.68 ± 81.39 P \ 0.05). similar superiority was detectable for migraine with aura and migraine without aura (p = 0.92) nor Intensity, Duration and Frequency of headaches. between group of migraine with and without aura (p = 0.76). We Conclusion We found trigger point injection more potent in com- found that FMD is not impaired in migraine patients, neither in parison to daily Gabapentin. This superiority was statistically those with nor without aura (p [ 0.05). Thus, it could be convinc- significant after 4 weeks and continued up to 8th week. It should be ingly concluded systemic endothelial function are not altered during noted that trigger point injection was more effective to decrease all the interictal period, but migraine could be associated with cerebral aspects of headache including intensity, duration and frequency. endothelial dysfunction. Keywords Chronic tension-type headache, Depomedrol, Trigger point, Gabapentin, Prophylactic 24 Orthostatic headache revealing multiple periradicular 26 cysts Blood-patch: immediate effective remedy for headaches secondary to dura mater injury J.A. Elosegi, C. Cuvelier, M. Rinkowski, Y. Khayat, C. Neugroschl, J.M. Gerard M.A. Hachimi Neurology, Hopital Ambroise Pare, Mons, Belgium Mohammed V, Mekne`s, Morocco Spontaneous postural headache was observed in a 49 years old Objective The aim of this study was to evaluate if bed rest during 2 h woman. MRI of the brain showed a Chairi I like aspect of the pos- in a supine posture is required to improve the efficacy
Load more

Recommended publications
  • Ayahuasca: Spiritual Pharmacology & Drug Interactions
    Ayahuasca: Spiritual Pharmacology & Drug Interactions BENJAMIN MALCOLM, PHARMD, MPH [email protected] MARCH 28 TH 2017 AWARE PROJECT Can Science be Spiritual? “Science is not only compatible with spirituality; it is a profound source of spirituality. When we recognize our place in an immensity of light years and in the passage of ages, when we grasp the intricacy, beauty and subtlety of life, then that soaring feeling, that sense of elation and humility combined, is surely spiritual. The notion that science and spirituality are somehow mutually exclusive does a disservice to both.” – Carl Sagan Disclosures & Disclaimers No conflicts of interest to disclose – I don’t get paid by pharma and have no potential to profit directly from ayahuasca This presentation is for information purposes only, none of the information presented should be used in replacement of medical advice or be considered medical advice This presentation is not an endorsement of illicit activity Presentation Outline & Objectives Describe what is known regarding ayahuasca’s pharmacology Outline adverse food and drug combinations with ayahuasca as well as strategies for risk management Provide an overview of spiritual pharmacology and current clinical data supporting potential of ayahuasca for treatment of mental illness Pharmacology Terms Drug ◦ Term used synonymously with substance or medicine in this presentation and in pharmacology ◦ No offense intended if I call your medicine or madre a drug! Bioavailability ◦ The amount of a drug that enters the body and is able to have an active effect ◦ Route specific: bioavailability is different between oral, intranasal, inhalation (smoked), and injected routes of administration (IV, IM, SC) Half-life (T ½) ◦ The amount of time it takes the body to metabolize/eliminate 50% of a drug ◦ E.g.
    [Show full text]
  • The Migraine Attack As a Homeostatic, Neuroprotective Response to Brain Oxidative Stress: Preliminary Evidence for a Theory
    ISSN 0017-8748 Headache doi: 10.1111/head.13214 VC 2017 American Headache Society Published by Wiley Periodicals, Inc. Views and Perspectives The Migraine Attack as a Homeostatic, Neuroprotective Response to Brain Oxidative Stress: Preliminary Evidence for a Theory Jonathan M. Borkum, PhD Background.—Previous research has suggested that migraineurs show higher levels of oxidative stress (lipid peroxides) between migraine attacks and that migraine triggers may further increase brain oxidative stress. Oxidative stress is trans- duced into a neural signal by the TRPA1 ion channel on meningeal pain receptors, eliciting neurogenic inflammation, a key event in migraine. Thus, migraines may be a response to brain oxidative stress. Results.—In this article, a number of migraine components are considered: cortical spreading depression, platelet acti- vation, plasma protein extravasation, endothelial nitric oxide synthesis, and the release of serotonin, substance P, calcitonin gene-related peptide, and brain-derived neurotrophic factor. Evidence is presented from in vitro research and animal and human studies of ischemia suggesting that each component has neuroprotective functions, decreasing oxidant production, upregulating antioxidant enzymes, stimulating neurogenesis, preventing apoptosis, facilitating mitochondrial biogenesis, and/or releasing growth factors in the brain. Feedback loops between these components are described. Limitations and challenges to the model are discussed. Conclusions.—The theory is presented that migraines are an integrated
    [Show full text]
  • PMA-Sio2: Heteropolyacid Catalysis for Michael Addition-Convenient Route to Substituted-3-Indoles
    Available online at www.derpharmachemica.com ISSN 0975-413X Der Pharma Chemica, 2017, 9(13):112-117 CODEN (USA): PCHHAX (http://www.derpharmachemica.com/archive.html) PMA-SiO2: Heteropolyacid Catalysis for Michael Addition-Convenient Route to Substituted-3-Indoles Vijay Kumar Pasala* Deapartment of Chemistry, Osmania University, Hyderabad-500007, Telangana, India ABSTRACT Synthesis of 3-substituted indoles in a hassel-free, ecofriendly manner by treating indoles with α, β-unsaturated carbonyl or nitro compounds under acidic conditions to give good to excellent yields with shorter reaction durations are described. The catalyst is recyclable for three to four times without great loss in the activity. Keywords: Phosphomolybdic Acid (PMA), Substituted indoles, α, β-unsaturated carbonyl compounds, α, β-unsaturated nitro compounds, Michael addition INTRODUCTION Heterocyclic chemistry is one of the quintessential branches of organic synthesis beaconing towards new scaffolds with medicinal values, new methodologies to the existing active principles etc. One among such skeletons is indole. It is perhaps the most common heterocycles in chemistry and its derivatives are obtained from coal pitch, variety of plants or by the bacterial decay of tryptophan in the intestine [1]. Indole derivatives serve as signaling chemicals in plants and animals, as nucleus building blocks (serotonin [2] (A) a crucial neurotransmitter in the central nervous system [3]), as antibacterial [4], antiviral [5], protein kinase inhibitors [6], anticancer agents [7], entheogens (psilocybin (B) causes perceptional changes), hormones (melatonin (C) regulates sleep and wakefulness), antidepressants (roxindole (D), bufotenin (E)), sumatriptan (F) for the treatment of migraine and ondansetron (G) for the suppression of nausea and vastly found in natural products such as alkaloids (Corynanthe, Iboga, and Aspidosperma alkaloids) [8-10], indigoids etc., which originate, either fully or partly, from bio-oxidation of indoles [11].
    [Show full text]
  • Pharmacokinetics, Pharmacodynamics and Drug
    pharmaceutics Review Pharmacokinetics, Pharmacodynamics and Drug–Drug Interactions of New Anti-Migraine Drugs—Lasmiditan, Gepants, and Calcitonin-Gene-Related Peptide (CGRP) Receptor Monoclonal Antibodies Danuta Szkutnik-Fiedler Department of Clinical Pharmacy and Biopharmacy, Pozna´nUniversity of Medical Sciences, Sw.´ Marii Magdaleny 14 St., 61-861 Pozna´n,Poland; [email protected] Received: 28 October 2020; Accepted: 30 November 2020; Published: 3 December 2020 Abstract: In the last few years, there have been significant advances in migraine management and prevention. Lasmiditan, ubrogepant, rimegepant and monoclonal antibodies (erenumab, fremanezumab, galcanezumab, and eptinezumab) are new drugs that were launched on the US pharmaceutical market; some of them also in Europe. This publication reviews the available worldwide references on the safety of these anti-migraine drugs with a focus on the possible drug–drug (DDI) or drug–food interactions. As is known, bioavailability of a drug and, hence, its pharmacological efficacy depend on its pharmacokinetics and pharmacodynamics, which may be altered by drug interactions. This paper discusses the interactions of gepants and lasmiditan with, i.a., serotonergic drugs, CYP3A4 inhibitors, and inducers or breast cancer resistant protein (BCRP) and P-glycoprotein (P-gp) inhibitors. In the case of monoclonal antibodies, the issue of pharmacodynamic interactions related to the modulation of the immune system functions was addressed. It also focuses on the effect of monoclonal antibodies on expression of class Fc gamma receptors (FcγR). Keywords: migraine; lasmiditan; gepants; monoclonal antibodies; drug–drug interactions 1. Introduction Migraine is a chronic neurological disorder characterized by a repetitive, usually unilateral, pulsating headache with attacks typically lasting from 4 to 72 h.
    [Show full text]
  • The Serotonergic System in Migraine Andrea Rigamonti Domenico D’Amico Licia Grazzi Susanna Usai Gennaro Bussone
    J Headache Pain (2001) 2:S43–S46 © Springer-Verlag 2001 MIGRAINE AND PATHOPHYSIOLOGY Massimo Leone The serotonergic system in migraine Andrea Rigamonti Domenico D’Amico Licia Grazzi Susanna Usai Gennaro Bussone Abstract Serotonin (5-HT) and induce migraine attacks. Moreover serotonin receptors play an impor- different pharmacological preventive tant role in migraine pathophysiolo- therapies (pizotifen, cyproheptadine gy. Changes in platelet 5-HT content and methysergide) are antagonist of are not casually related, but they the same receptor class. On the other may reflect similar changes at a neu- side the activation of 5-HT1B-1D ronal level. Seven different classes receptors (triptans and ergotamines) of serotoninergic receptors are induce a vasocostriction, a block of known, nevertheless only 5-HT2B-2C neurogenic inflammation and pain M. Leone • A. Rigamonti • D. D’Amico and 5HT1B-1D are related to migraine transmission. L. Grazzi • S. Usai • G. Bussone (౧) syndrome. Pharmacological evi- C. Besta National Neurological Institute, Via Celoria 11, I-20133 Milan, Italy dences suggest that migraine is due Key words Serotonin • Migraine • e-mail: [email protected] to an hypersensitivity of 5-HT2B-2C Triptans • m-Chlorophenylpiperazine • Tel.: +39-02-2394264 receptors. m-Chlorophenylpiperazine Pathogenesis Fax: +39-02-70638067 (mCPP), a 5-HT2B-2C agonist, may The 5-HT receptor family is distinguished from all other 5- Introduction 1 HT receptors by the absence of introns in the genes; in addi- tion all are inhibitors of adenylate cyclase [1]. Serotonin (5-HT) and serotonin receptors play an important The 5-HT1A receptor has a high selective affinity for 8- role in migraine pathophysiology.
    [Show full text]
  • Triptans Step Therapy/Quantity Limit Criteria
    Triptans Step Therapy/Quantity Limit Criteria Program may be implemented with the following options 1) step therapy 2) quantity limits or 3) step therapy with quantity limits For Blue Cross and Blue Shield of Illinois Option 1 (step therapy only) will apply. Brand Generic Dosage Form Amerge® naratriptan tablets Axert® almotriptan tablets Frova® frovatriptan tablets Imitrex® sumatriptan injection*, nasal spray, tablets* Maxalt® rizatriptan tablets Maxalt-MLT® rizatriptan tablets Relpax® eletriptan tablets Treximet™ sumatriptan and naproxen tablets Zomig® zolmitriptan tablets, nasal spray Zomig-ZMT® zolmitriptan tablets * generic available and included as target agent in quantity limit edit FDA APPROVED INDICATIONS1-7 The following information is taken from individual drug prescribing information and is provided here as background information only. Not all FDA-approved indications may be considered medically necessary. All criteria are found in the section “Prior Authorization Criteria for Approval.” Amerge® Tablets1, Axert® Tablets2, Frova® Tablets3,Imitrex® injection4, Imitrex Nasal Spray5, Imitrex Tablets6, Maxalt® Tablets7, Maxalt-MLT® Tablets7, Relpax® Tablets8, Treximet™ Tablets9, Zomig® Tablets10, Zomig-ZMT® Tablets10, and Zomig® Nasal Spray11 Amerge (naratriptan), Axert (almotriptan), Frova (frovatriptan), Imitrex (sumatriptan), Maxalt (rizatriptan), Maxalt-MLT (rizatriptan orally disintegrating), Relpax (eletriptan), Treximet (sumatriptan/naproxen), Zomig (zolmitriptan), and Zomig-ZMT (zolmitriptan orally disintegrating) tablets, and Imitrex (sumatriptan) and Zomig (zolmitriptan) nasal spray are all indicated for the acute treatment of migraine attacks with or without aura in adults. They are not intended for the prophylactic therapy of migraine or for use in the management of hemiplegic or basilar migraine. Safety and effectiveness of all of these products have not been established for cluster headache, which is present in an older, predominantly male population.
    [Show full text]
  • (DMT), Harmine, Harmaline and Tetrahydroharmine: Clinical and Forensic Impact
    pharmaceuticals Review Toxicokinetics and Toxicodynamics of Ayahuasca Alkaloids N,N-Dimethyltryptamine (DMT), Harmine, Harmaline and Tetrahydroharmine: Clinical and Forensic Impact Andreia Machado Brito-da-Costa 1 , Diana Dias-da-Silva 1,2,* , Nelson G. M. Gomes 1,3 , Ricardo Jorge Dinis-Oliveira 1,2,4,* and Áurea Madureira-Carvalho 1,3 1 Department of Sciences, IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; [email protected] (A.M.B.-d.-C.); ngomes@ff.up.pt (N.G.M.G.); [email protected] (Á.M.-C.) 2 UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal 3 LAQV-REQUIMTE, Laboratory of Pharmacognosy, Department of Chemistry, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal 4 Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal * Correspondence: [email protected] (D.D.-d.-S.); [email protected] (R.J.D.-O.); Tel.: +351-224-157-216 (R.J.D.-O.) Received: 21 September 2020; Accepted: 20 October 2020; Published: 23 October 2020 Abstract: Ayahuasca is a hallucinogenic botanical beverage originally used by indigenous Amazonian tribes in religious ceremonies and therapeutic practices. While ethnobotanical surveys still indicate its spiritual and medicinal uses, consumption of ayahuasca has been progressively related with a recreational purpose, particularly in Western societies. The ayahuasca aqueous concoction is typically prepared from the leaves of the N,N-dimethyltryptamine (DMT)-containing Psychotria viridis, and the stem and bark of Banisteriopsis caapi, the plant source of harmala alkaloids.
    [Show full text]
  • Daily Triptans for Headache
    Expert Opinion Daily Triptans for Headache Case History Submitted by Randolph W. Evans, MD Expert Opinion by Lawrence Robbins, MD Key words: headache, triptans Abbreviations: CDH chronic daily headache (Headache 2001;41:907-909) Will a triptan a day keep the headache away? I advised the patient that the increased frequency of the headaches could be rebound due to sumatriptan CLINICAL HISTORY and that the headaches might decrease by restricting This 47-year-old woman has a history of migraine the sumatriptan to no more than 2 days per week and since aged 4 years. Until 1 year ago, the headaches oc- starting another preventative such as sodium valpro- curred one to two times per week, lasted all day, re- ate. She is concerned about the possible side effects sulted in functional incapacity, and were not relieved of sodium valproate, which she has read can make you by over-the-counter medications or nonsteroidal anti- fat and bald. She also stated that the headaches were inflammatory drugs. About 10 years ago, she was tak- quite tolerable with the daily sumatriptan and she ing Fiorinal #3 but stopped when she developed could not see the difference between taking daily rebound headaches. She has been on multiple preven- sumatriptan as compared to a preventative which may tative medications including amitriptyline, ␤-blockers, or may not work and may have significant side effects. paroxetine, fluoxetine, and verapamil which were ei- Questions.—Is there evidence to support daily ther not effective or stopped due to side effects. triptan use for migraine? What would you recom- One year ago, she saw another neurologist and mend in this case? had an MRI scan of the brain with normal findings.
    [Show full text]
  • Medication Guide 2012
    DeKalb County D.U.I. Court Supervised Treatment Program MEDICATION GUIDE Medication Guide 2012 DeKalb County State Court Decatur, Georgia xxi ********** WELCOME TO THE DEKALB COUNTY D.U.I. COURT SUPERVISED TREATMENT PROGRAM. This 2012 Medication Guide was developed as a collaborative effort by Becky Pirouz, Pharm.D., Director of Pharmacy, Peachford Hospital, and by Lois Michalove, Treatment Coordinator for the DeKalb County D.U.I. Court Supervised Treatment Program, both of whom have extensive experience in addiction recovery and treatment. ********** The following information is intended to assist you in making decisions about medications. This may include those medications that you are prescribed and/or your selection of over-the-counter (OTC) products. Unintended exposure may compromise your treatment program. This is not an exhaustive list, but contains some of the medications that are most commonly used. If in doubt, always consult the Treatment Coordinator. Please inform your physician, dentist, pharmacist and other health care professionals that you are in a recovery program. WE ARE A ZERO-TOLERANCE PROGRAM! DO NOT COMPROMISE YOUR RECOVERY BY MAKING HIGH-RISK CHOICES! xxii - Section 1 – Drugs To Avoid The following drugs must not be used at any time. They are well known to be abused and even small amounts may result in relapse and are contraindicated in your treatment program. However, extenuating circumstances may occur which necessitates the short- term limited use of some of the drugs on this list in consultation with your physician, the Judge and the Treatment Coordinator. This decision should be made prior to your ingestion of any of the Drugs to Avoid.
    [Show full text]
  • The Impact of Triptan and Doxycycline on Neuroinflammatory Biomarkers in Acute Migraine: Study Protocol of a Randomized Controlled Trial Study Protocol
    iMedPub Journals INTERNATIONAL ARCHIVES OF MEDICINE 2015 http://journals.imed.pub SECTION: NEUROLOGY Vol. 8 No. 13 ISSN: 1755-7682 doi: 10.3823/1612 The impact of triptan and doxycycline on neuroinflammatory biomarkers in acute migraine: study protocol of a randomized controlled trial STUDY PROTOCOL Shaheen E Lakhan, MD, Abstract PhD, MEd, MS1 Background: Increased inflammatory cytokines and matrix meta- 1 Neurological Institute, Cleveland Clinic, lloproteinases (MMPs) have been recently implicated in migraine. In- Euclid Ave, S100C, Cleveland OH . flammation may be a key player in the pathophysiology of migraine by altering blood-brain barrier (BBB) function. As an inflammation induced MMP, MMP-9 is involved in both BBB disruption and neuro- Contact information: pathic pain, and is largely derived by neutrophil degranulation during neutrophil-BBB interaction. The tetracycline group of antibiotics may Shaheen E Lakhan, MD, PhD, MEd, MS. Neurological Institute, Cleveland Clinic, suppress MMP production and neutrophil degranulation. 9500 Euclid Ave, S100C, Cleveland OH 44195. Methods/Design: We hypothesize that migraine is a primary neu- Tel: (216) 444-2200 roinflammatory disorder. We will address this theory by measuring serum biomarkers in healthy controls and after one of three abortive slakhan @gnif.org therapy strategies for acute migraine attacks and inter-ictally. We intend to investigate known neuroinflammatory biomarkers with a focus on BBB breakdown during acute migraine attacks and assess marker responses to conventional treatment (triptans), novel MMP targeted therapy (doxycycline), or a combination of triptan and do- xycycline. We will measure the effects of the interventions on neu- roinflammatory markers for acute migraine attacks, clinical outcomes (headache relief and recurrence) for acute migraine attacks, inter- ictal neuroinflammatory load per serum biomarkers in migraineurs versus healthy controls, and neuroinflammatory markers correlation with headache duration and peak headache intensity during acute migraine attacks.
    [Show full text]
  • Guideline for Preoperative Medication Management
    Guideline: Preoperative Medication Management Guideline for Preoperative Medication Management Purpose of Guideline: To provide guidance to physicians, advanced practice providers (APPs), pharmacists, and nurses regarding medication management in the preoperative setting. Background: Appropriate perioperative medication management is essential to ensure positive surgical outcomes and prevent medication misadventures.1 Results from a prospective analysis of 1,025 patients admitted to a general surgical unit concluded that patients on at least one medication for a chronic disease are 2.7 times more likely to experience surgical complications compared with those not taking any medications. As the aging population requires more medication use and the availability of various nonprescription medications continues to increase, so does the risk of polypharmacy and the need for perioperative medication guidance.2 There are no well-designed trials to support evidence-based recommendations for perioperative medication management; however, general principles and best practice approaches are available. General considerations for perioperative medication management include a thorough medication history, understanding of the medication pharmacokinetics and potential for withdrawal symptoms, understanding the risks associated with the surgical procedure and the risks of medication discontinuation based on the intended indication. Clinical judgement must be exercised, especially if medication pharmacokinetics are not predictable or there are significant risks associated with inappropriate medication withdrawal (eg, tolerance) or continuation (eg, postsurgical infection).2 Clinical Assessment: Prior to instructing the patient on preoperative medication management, completion of a thorough medication history is recommended – including all information on prescription medications, over-the-counter medications, “as needed” medications, vitamins, supplements, and herbal medications. Allergies should also be verified and documented.
    [Show full text]
  • UCSF UC San Francisco Electronic Theses and Dissertations
    UCSF UC San Francisco Electronic Theses and Dissertations Title Deep phenotypic profiling of neuroactive drugs in larval zebrafish Permalink https://escholarship.org/uc/item/3vk1d0gr Author Gendelev, Leo Publication Date 2019 Peer reviewed|Thesis/dissertation eScholarship.org Powered by the California Digital Library University of California Deep phenotypic profiling of neuro-active drugs in larval Zebrafish by Lev Gendelev DISSERTATION Submitted in partial satisfaction of the requirements for degree of DOCTOR OF PHILOSOPHY in Biophysics in the GRADUATE DIVISION of the UNIVERSITY OF CALIFORNIA, SAN FRANCISCO Approved: ______________________________________________________________________________Michael Keiser Chair ______________________________________________________________________________DAVID KOKEL ______________________________________________________________________________Jim Wells ______________________________________________________________________________ ______________________________________________________________________________ Committee Members Copyright 2019 by Lev (Leo) Gendelev ii In Loving Memory of My Mother, Lucy Gendelev iii Acknowledgements First of all, I thank my advisor, Michael Keiser, for his unwavering support through the most difficult of times. I will above all else reminisce over our brainstorming sessions, where my half- wrought white-board scribbles were met with enthusiasm and sometimes even developed into exciting side-projects. My PhD experience felt less like work and more like a fantastical scientific
    [Show full text]