The Influence of Thiethylperazine on the Absorption of Effervescent Aspirin in Migraine

Wainscott, Gillian; Kaspi, T

doi:10.1111/j.1365-2125.1976.tb00351.x

Cited by 16 publications

(7 citation statements)

References 12 publications

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“…metoclopramide 10 mg could correct the impairment of the absorption of effervescent aspirin during a migraine attack, whereas this was not the case with i.m. antiemetic thiethylperazine 10 mg (20). Rectal metoclopramide 20 mg could correct the impaired absorption of oral tolfenamic acid (7), an NSAID with proven efficacy in migraine (33).…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, a 10 mg i.m. dose of thiethylperazine, a phenothiazine antiemetic drug without prokinetic effect, could not normalise the absorption of effervescent aspirin (20).…”

Section: Discussionmentioning

confidence: 99%

“…In total 12 studies (6)(7)(8)(9)11,12,(15)(16)(17)(18)(19)(20) on drug absorption were included, as were five studies (13,(21)(22)(23)(24) on gastric emptying during and outside migraine attacks. In addition, also included were three double-blind, cross-over clinical trials (25)(26)(27) investigating the possible effects on headache and nausea of combining metoclopramide or domperidone with analgesics or an NSAID.…”

Section: Studies Includedmentioning

confidence: 99%

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Delayed absorption of many (paracetamol, aspirin, other NSAIDs and zolmitriptan) but not all (sumatriptan, rizatriptan) drugs during migraine attacks and most likely normal gastric emptying outside attacks. A review

Tfelt‐Hansen

2016

Cephalalgia

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Background In most pharmacokinetic studies, the oral absorption of drugs is impaired during migraine attacks but exceptions occur. A study on gastric emptying using gastric scintigraphy indicated that gastric stasis also occurs interictally in migraine. These studies were reviewed critically. Results In seven studies, mainly investigating NSAIDs and analgesics, the early absorption of the drugs during 112 migraine attacks was delayed. The absorption of sumatriptan is usual in therapeutic doses, and rizatriptan was normal during 131 migraine attacks. The interictal gastric stasis observed using gastric emptying scintigraphy (GES) with solids ( n = 13) could not be confirmed in a larger study ( n = 27) using the same method. Also gastric emptying measured with GES with liquids ( n = 7) and epigastric impedance ( n = 64) was normal outside migraine attacks. Conclusions and possible clinical implications Drug absorption is not generally impaired during migraine attacks. Gastric emptying is most likely normal in the majority of migraine patients outside attacks. Prokinetic and antiemetic drugs such as metoclopramide and domperidone should not be routinely combined with oral analgesics or oral triptans. If, however, nausea is severe or vomiting occurs, treatment with an antiemetic with proven efficacy on the nausea of migraine can be indicated.

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Section: Resultsmentioning

confidence: 99%

“…In contrast, a 10 mg i.m. dose of thiethylperazine, a phenothiazine antiemetic drug without prokinetic effect, could not normalise the absorption of effervescent aspirin (20).…”

Section: Discussionmentioning

confidence: 99%

Section: Studies Includedmentioning

confidence: 99%

See 1 more Smart Citation

Delayed absorption of many (paracetamol, aspirin, other NSAIDs and zolmitriptan) but not all (sumatriptan, rizatriptan) drugs during migraine attacks and most likely normal gastric emptying outside attacks. A review

Tfelt‐Hansen

2016

Cephalalgia

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“…10,11 Thus, it is preferred over chlorpromazine which slows gastro-intestinal motility and over antihistamines, which do not increase absorption. 12 In our hands, metoclopramide has been extremely effective, alleviating nausea and vomiting in more than 90% of the cases. Metoclopramide i.m.…”

mentioning

confidence: 76%

The Copenhagen acute headache clinic: organization, patient material and treatment results

Olssen¹,

Aebelholt²,

Veilis³

1980

Pain

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SYNOPSISThe Copenhagen Acute Headache Clinic is part of the neurological department of the University Hospital. Patients with acute attacks of headache are treated day or night by the neurological nursing staff and residents. A standard history and examination is used. 88% of all headache patients had migraine. They were treated with metoclopramide 10 mg. i.m. for nausea/ vomiting and to speed up gastric emptying. Mild analgesics (acetylsalicylic acid 1 gm. or acetaminophen 1 gm. p.o.) and a tranquilizer (diazepam 5 mg. p.o.) were also given. 67% left symptom-free. 25% left with only mild headache and the remainder left with moderate pain or unimproved. Median time in hospital was four hours. There was no correlation between the length of the attack at the time of arrival and the treatment result. Patients with frequent, severe migraine, (judged by the number of previous house calls) responded as well as others. Patients who had previously used morphine-like drugs, also responded well to our standard treatment. It is concluded that treatment of migraine patients in-hospital is worthwhile and economically acceptable when combined with research and teaching. (Headache 19:223-227, 1979) Considering the high incidence of severe headache, particularly migraine, surprisingly little research is being conducted in this area. One reason may be that the psychosomatic nature of most headache types makes research difficult. But it is probably more important that chronic headache cases are only rarely hospitalized, and that acute attacks of headache are rarely observed in a hospital setting. Headache is a disease of general and specialist practices, where research expertise and resources are usually limited.Remarkable research initiatives have been taken by many practicing specialists despite all difficulties, but clearly, more hospital based research is needed. The British acute migraine clinics have demonstrated that "in-hospital" treatment of migraine can be organized to the advantage of the patients. This has also given considerable impetus to migraine research. 1,2 Inspired by the British example, we have organized a clinic for the treatment of acute headache attacks in the neurological department of the University Hospital of Copenhagen (Rigshospitalet). The present paper describes the organization of the clinic and the results with the first 750 acute migraine patients. THE ORGANIZATION OF THE CLINICRigshospitalet (University Hospital) is a newly constructed 2,000 bed teaching hospital located in central Copenhagen. The neurological department has 90 beds, all in two-bed rooms. Two rooms have been used for the acute headache cases.The rooms are part of a previously designed and staffed 15-bed nursing unit. When the two rooms were converted into the headache clinic, no increase in staff took place. The original nursing staff takes care of both the acute headaches and the ordinary neurological patients in the remaining 11 beds.

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“…As gastric stasis is present in migraine (Kaufman & Levine, 1936;Kreel, 1969) it is important that the analgesic is given in the most readily absorbed formulation. Volans (1974Volans ( , 1975a and Wainscott, Kaspi & Volans (1976) used effervescent aspirin in their studies of salicylate absorption during migraine headache, but no claims have ever been made for the efficacy of effervescent aspirin in migraine compared with other rapidly absorbed formulations other than its pleasant taste and low sodium content (Volans, 1975b). Effervescent preparations of aspirin (Leonards, 1963) Saltzman (1948) using an AmincoBowman spectrophotofluorimeter.…”

Section: Plasma Salicylate Levels After Soluble and Effervescent Aspirinmentioning

confidence: 99%

Plasma salicylate levels after soluble and effervescent aspirin.

Orton¹,

Jones²,

Kaspi³

et al. 1979

Brit J Clinical Pharma

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The Influence of Thiethylperazine on the Absorption of Effervescent Aspirin in Migraine

Cited by 16 publications

References 12 publications

Delayed absorption of many (paracetamol, aspirin, other NSAIDs and zolmitriptan) but not all (sumatriptan, rizatriptan) drugs during migraine attacks and most likely normal gastric emptying outside attacks. A review

Delayed absorption of many (paracetamol, aspirin, other NSAIDs and zolmitriptan) but not all (sumatriptan, rizatriptan) drugs during migraine attacks and most likely normal gastric emptying outside attacks. A review

The Copenhagen acute headache clinic: organization, patient material and treatment results

Plasma salicylate levels after soluble and effervescent aspirin.

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