Tag Archives: Verapamil

Pharmacological Treatment of Pain

While medications are often prescribed for all types of chronic pain, research has consistently shown that several classes have proven efficacy for the treatment of neuropathic pain. Ideally, pharmacotherapy of pain would be specifically selected on the basis of considerations of etiology (e.g., ischemic, neuropathic), pathophysiology (e.g., demyelination, central pain), and anatomy (e.g., C fibers,… Read More »

Chronic Illness: Current Therapies

The main goal of bipolar disorder drug treatment is to establish euthymia (stable mood with a persistent sense of well-being) without inducing mania or rapid cycling (i.e., four or more mood episodes in a 12-month period). For this reason, drug treatment usually consists of an agent or, more frequently, combinations of agents that exert both… Read More »

Preventive Treatment for Migraine

Migraine is a common episodic headache disorder characterized by attacks that consist of various combinations of headache and neurologie, gastrointestinal, and autonomie symptoms. It has a one-year prevalence of approximately 18% in women, 6% in men, and 4% in children. The second edition of the International Classification of Headache Disorders (ICHD-2) subclassifies migraine into migraine… Read More »

Specific Migraine-Preventive Agents: Calcium-Channel Antagonists

Calcium, in combination with a calcium-binding protein such as calmodulin or troponin, regulates many functions, including muscle contraction, neurotransmitter and hormone release, and enzyme activity. Its extracellular concentration is high; its intracellular free concentration is 10,000-fold smaller. The concentration gradient is established by membrane pumps and the intracellular sequestering of free calcium. When stimulated, the… Read More »

Treatment of the epilepsy patient with hepatic disease

The liver is the principal organ of drug metabolism. Some drugs are absorbed from the gut, delivered to the liver and undergo first-pass metabolism prior to reaching the systemic circulation. Metabolism of these drugs is significantly affected by hepatic vascular supply; if hepatic blood flow is reduced, first-pass metabolism is decreased and more drug reaches… Read More »

Headache

Headache which is not due to intracranial or systemic pathology is described as primary headache. Primary headaches are appropriately treated in the pain clinic, whereas secondary headaches require investigation. Diagnosis is made by history. Examination and investigations may be necessary to exclude secondary headache. Diagnostic criteria have been defined by the Headache Classification Committee of… Read More »

Migraine

Migraine is a primary headache. Diagnosis can be made from the history. However, investigation may be required to exclude headache of other aetiology. Pathophysiology There are vascular and neural hypotheses. The ophthalmic division of the trigeminal nerve supplies painful structures within the head. Stimulation of the trigeminal ganglion releases a peptide from trigeminal neurones which… Read More »

The drugs used for blood pressure control and headache prevention

The following medications are used for blood pressure control and headache prevention. Match each with it mechanism of action. Use each answer once, more than once, or not at all. A. Lisinopril (Prinivil, Zestril) B. Candesartan (Atacand) C. Atenolol (Tenormin) D. Verapamil (Calan) E. Clonidine (Catapres) 1. a2 Agonists 2. Angiotensin II receptor blocker 3.… Read More »

Clinical trials of sham versus real acupuncture…

Which of the following statements describes clinical trials of sham versus real acupuncture? A. Patients with TTHs respond to both types of acupuncture. B. Patients with migraine headaches respond to both types of acupuncture. C. Acupuncture may show benefit similar to preventative medication in migraine patients. D. The psychological and physiologic benefits of acupuncture cannot… Read More »

Which of the drugs, used to prevent migraine in adults, has been most extensively studied in children and adolescents?

Which of the following medications, used to prevent migraine headaches in adults, has been most extensively studied in children and adolescents? A. Topiramate (Topamax) B. Valproic acid (Depakene) C. Verapamil (Calan) D. Amitriptyline (Elavil) E. Fluoxetine (Prozac) The answer is A. Topiramate (Topamax) has been studied in children with pediatric migraine with or without aura,… Read More »