The pharmacologic treatment of acute migraine headaches

Klapper, Jack A.

doi:10.1016/0885-3924(93)90142-i

Cited by 11 publications

(16 citation statements)

References 49 publications

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“…According to this hypothesis, which is largely supported by the clinical observations showing that both corticosteroids and nonsteroidal anti inflammatory drugs (NSAIDs) are effective in aborting migraine [Klapper, 1993], such inflammation ensues as a consequence of a single or multiple episodes of cortical spreading depression (CSD), an intrinsic brain activity that is considered the neural substrate of the migrainous aura [Moskowitz, 2007]. CSD is associated with local release of algesic mediators such as potassium and glutamate into the intracranial space [Lauritzen, 2001], which have the potential to promote a brief activation of trigeminal (presumably meningeal) nociceptors [Bolay et al, 2002].…”

Section: Introductionmentioning

confidence: 89%

Meningeal mast cells, inflammation and migraine pain

Levy

2007

Drug Development Research

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Migraine is a debilitating, throbbing headache that afflicts about 15% of the Western population. While the underlying cause of migraine is still a matter of speculation, the intracranial throbbing pain of migraine is largely attributed to an episode of local sterile meningeal inflammation that promote activation of trigeminal mechanosensitive nociceptive afferents that supply the meninges. The key players responsible for triggering such nociceptive neuronal events remain poorly defined, however. Mast cells, resident inflammatory cells that populate the meninges, particularly the dura mater, were implicated in the pathophysiology of migraine more than 50 years ago. Additional clinical and preclinical data that further support their role in migraine have recently emerged. This review highlights these findings, examines the evidence of a neuroimmune interaction between meningeal nociceptors and mast cells, in particular their involvement in promoting the activation and sensitization of the trigeminovascular systems, and will finally discuss the notion that in some migraine attacks, mast cells serve as an intermediate between various migraine triggers and the persistent activation of meningeal nociceptors. Drug Dev Res 68: 412-418, 2007.

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Section: Introductionmentioning

confidence: 89%

Meningeal mast cells, inflammation and migraine pain

Levy

2007

Drug Development Research

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“…Sama droga se ne koristi u terapiji već služi za ekstrakciju ergot alkaloida od kojih ulogu u terapiji migrene ima ergotamin [9]. To je ergo-peptidni alkaloid, derivat lizergne kiseline.…”

Section: T C Zunclassified

Herbs and natural products in prevention and treatment of migraine

Ilić¹

2014

Lek sirovine

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IZVODMigrenske glavobolje su izuzetno česte i smatra se da, u proseku, svaki deseti stanovnik pati od migrene. Patogeneza migrene nije u potpunosti razjašnjena. Postoje dve teorije, vaskularna i neurogena. Terapija migrene podrazumeva prevenciju i terapiju akutnog napada. Kod osoba kod kojih su migrenozni napadi izrazito česti (2 ili više napada mesečno), intenzivni, dugi, kao i "otporni" na akutnu terapiju, preporučuje se preventivna terapija. Jedna od najvažnijih biljaka u terapiji migrene je vrsta Tanacetum parthenium, Asteraceae, povratić. Najznačajniji aktivni sastojci nadzemnog dela ove biljke su seskviterpenski α-metilenbutirolaktoni. Dominantno jedinjenje ove grupe je partenolid -seskviterpenski lakton germakrenolidnog tipa. Partenolid se smatra nosiocem antimigrenoznog delovanja. Pokazani je da partenolid, kao glavni aktivni sastojak povratića, sadrži visoko elektrofilni α-metilen-γ-laktonski prsten i epoksid, koji direktno interaguju sa nukleofilnim grupama bioloških molekula. Između ostalog (inhibicija agregacije trombocita, transkripcije NF-κB i IKCa), partenolid inhibira oslobađanje serotonina. Takođe, ergo-peptidni alkaloid ergotamin, produkt metabolizma gljive ražena glavnica (Claviceps purpurea) ispoljava antimigrenoznu aktivnost. Deluje kao parcijalni agonist α-adrenergičkih receptora što objašnjava vazakonstriktornu aktivnost. Na nivou 5-HT receptora deluje kao parcijalni agonist i to može objasniti primenu u terapiji migrene.

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“…Comparisons of this protocol against "typical" treatment with meperidine and promethazine showed similar efficacy with significantly fewer side effects in the DHE/ metoclopramide group [21], making it very useful for office-based treatment of migraines. One study evaluated the same protocol in a headache clinic against IV ketorolac and found the DHE protocol to result in a greater degree of improvement and better function clinically [22]. Various IV protocols available for clinic use were subsequently summarized by the same author [23].…”

Section: Intravenous Dihydroergotaminementioning

confidence: 99%

Intravenous treatment of chronic daily headaches in the outpatient headache clinic

Krusz

2006

Current Science Inc

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The most likely future of aggressive headache treatment will reside in the sphere of the specialist's clinic. This is a far more cost- and time-effective mode of treating intractable chronic daily headaches (CDH), including chronic migraines. We have used this technique successfully in our clinic for many years. Our experience with intravenous treatment of headaches and migraines was summarized recently and a 97.5% success rate for this type of treatment was found in the clinic. Compared with the treatments commonly available in the emergency department, the specialist's clinic can offer more effective headache-altering definitive treatments. Patients can be offered a maximum degree of success for control of their intractable headaches. In this article, approaches to aggressive treatment of ongoing CDH using intravenous methods of therapy are discussed. All of these can be performed in the clinic setting, avoiding some of the costly aspects of treatment that are present in an emergency room setting.

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The pharmacologic treatment of acute migraine headaches

Cited by 11 publications

References 49 publications

Meningeal mast cells, inflammation and migraine pain

Meningeal mast cells, inflammation and migraine pain

Herbs and natural products in prevention and treatment of migraine

Intravenous treatment of chronic daily headaches in the outpatient headache clinic

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