偏头痛 头痛 预防 预防
Paige Moreland1, Brody Gaffney2, Jason S Lanham3
1General Leonard Wood Army Community Hospital, Fort Leonard Wood, Missouri.
American family physician
|May 16, 2025
概括
偏头痛预防的目的是减少头痛的频率和严重程度. 第一线治疗包括诸如普拉诺洛尔和托皮拉等药物,在慢性偏头痛中有效的OnabotulinumtoxinA.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 偏头痛影响美国1%的人口,导致严重的残疾.
- 有效的偏头痛预防对于改善患者的生活质量和减少头痛负担至关重要.
研究的目的:
- 审查偏头痛预防的目标,指示和可用的治疗选择.
- 讨论一线和二线药物治疗,以及偏头痛管理的非药物干预措施.
主要方法:
- 对当前偏头痛预防的指导方针和证据的文献综述.
- 对一线药物 (例如,普拉诺洛尔,托皮拉玛酸,CGRP抗体),二线选择 (例如,阿米特利普提林) 和OnabotulinumtoxinA.的分析.
- 包括非药理学方法,如认知行为疗法和替代药物.
主要成果:
- 第一线药物治疗包括β-阻断剂,抗药和CGRP对抗剂,尽管成本可能是后者的障碍.
- 无胺毒素A对慢性偏头痛有效,耐受性良好,并具有较低的断药率.
- 非药物选择和替代药物,如和黑激素提供额外的治疗策略.
结论:
- 偏头痛预防涉及多方面的方法,包括触发管理和各种治疗方式.
- 治疗选择应考虑疗效,不良事件,成本和患者偏好以获得最佳结果.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
171
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
171
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
147
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
147
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
209
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...
209
Cholinergic Antagonists: Therapeutic Uses
699
Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
699
Cholinergic Antagonists: Pharmacokinetics
395
Cholinergic antagonists—such as antimuscarinics—are available in oral, topical, ocular, parenteral, and inhalational formulations. Most antimuscarinics are oral formulations, while scopolamine is available as a topical patch, and ipratropium and tiotropium are available as inhalation aerosols or powders. Atropine, tropicamide, and cyclopentolate are topically instilled in the eye. Most antimuscarinics are lipid-soluble and readily absorbed from the gastrointestinal tract and...
395
Antiasthma Drugs: Methylxanthines
166
Theophylline, a member of the methylxanthine class of bronchodilators, has long been used in asthma management. While its exact mechanism of action is not fully understood, it is believed to have multiple effects on various cellular processes.
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
166


