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[PMID]:28615428
[Au] Autor:Tso AR; Patniyot IR; Gelfand AA; Goadsby PJ
[Ad] Endereço:From the Headache Group (A.R.T., I.R.P., A.A.G., P.J.G.), Department of Neurology, University of California, San Francisco; Headache Group (A.R.T., P.J.G.), Basic and Clinical Neuroscience, King's College London; and NIHR, Wellcome Trust King's Clinical Research Facility, King's College Hospital, Lo
[Ti] Título:Increased rate of venous thrombosis may be associated with inpatient dihydroergotamine treatment.
[So] Source:Neurology;89(3):279-283, 2017 Jul 18.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To review whether the incidence of catheter-associated venous thromboses was higher in patients receiving IV dihydroergotamine compared to lidocaine. METHODS: We retrospectively reviewed all admissions at the University of California, San Francisco Headache Center from February 25, 2008, through October 31, 2014, for age, sex, diagnosis, aura, treatment dose, type of IV line used, days with line, superficial (SVT) or deep venous thrombosis (DVT), and pulmonary embolism (PE). RESULTS: A peripherally inserted central catheter (PICC) or midline catheter was placed in 315 of 589 (53%) admissions. Mean age was 38 years with a range of 6 to 79 years; 121 patients (21%) were ≤18 years old. Seventy-four percent (433 of 589) of patients were female. Of 263 dihydroergotamine admissions using a PICC or midline catheter, 19 (7.2%) had either an SVT or DVT or a PE; 2 patients were diagnosed with both DVT and PE. Of 52 lidocaine admissions using a PICC or midline catheter, none had a thrombotic event ( = 0.05, Fisher exact test). Age, sex, aura, total dihydroergotamine dose, and number of days with line were not significant predictors of venous thrombosis. CONCLUSIONS: IV dihydroergotamine treatment may be associated with an increased risk of catheter-associated venous thrombosis. A low threshold for diagnostic ultrasound investigation is appropriate because anticoagulation therapy was frequently required.
[Mh] Termos MeSH primário: Analgésicos não Entorpecentes/administração & dosagem
Analgésicos não Entorpecentes/efeitos adversos
Di-Hidroergotamina/administração & dosagem
Di-Hidroergotamina/efeitos adversos
Pacientes Internados
Trombose Venosa/epidemiologia
[Mh] Termos MeSH secundário: Administração Intravenosa/efeitos adversos
Administração Intravenosa/instrumentação
Adolescente
Adulto
Idoso
Cateteres de Demora/efeitos adversos
Criança
Feminino
Seres Humanos
Incidência
Pacientes Internados/estatística & dados numéricos
Lidocaína/administração & dosagem
Lidocaína/efeitos adversos
Masculino
Meia-Idade
Análise Multivariada
Estudos Retrospectivos
Centros de Atenção Terciária
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 436O5HM03C (Dihydroergotamine); 98PI200987 (Lidocaine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170727
[Lr] Data última revisão:
170727
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004108


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[PMID]:27793777
[Au] Autor:Muzzi M; Buonvicino D; De Cesaris F; Chiarugi A
[Ad] Endereço:Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Italy. Electronic address: mirko.muzzi@unifi.it.
[Ti] Título:Acute and chronic triptan exposure neither alters rodent cerebral blood flow nor worsens ischemic brain injury.
[So] Source:Neuroscience;340:1-7, 2017 Jan 06.
[Is] ISSN:1873-7544
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although it is still debated whether vasoconstriction underlies migraine resolution by triptans, they are not recommended in patients at cardiovascular risk. However, relationship between stroke incidence and triptan use is unclear, and it is unknown whether acute or chronic use of these drugs worsens ischemic brain injury. To address this issue, we investigated the effect of clinically-relevant doses of the potent cerebral artery vasoconstrictor eletriptan on cerebral blood flow (CBF) and brain infarct volumes, as well as on expression of genes involved in cerebrovascular regulation. We report that acute treatment of rats or mice with eletriptan did not reduce basal CBF, which promptly dropped upon treatment with prazosin or dihydroergotamine. Acute of chronic (1month) eletriptan also did not affect CBF changes and infarct volumes in mice undergoing brain ischemia/reperfusion. Finally, chronic eletriptan reduced brain mRNAs for PACAP and VIP, leaving unaffected those for 5HT1 R and CGRP. No significant transcript changes were found in dura mater. Data suggest that the impact of triptans on cerebral hemodynamic should be re-evaluated, as well as their propensity to increase stroke risk in migraineurs.
[Mh] Termos MeSH primário: Isquemia Encefálica/fisiopatologia
Córtex Cerebral/efeitos dos fármacos
Circulação Cerebrovascular/efeitos dos fármacos
Pirrolidinas/farmacologia
Agonistas de Receptores de Serotonina/farmacologia
Triptaminas/farmacologia
[Mh] Termos MeSH secundário: Animais
Anti-Hipertensivos/farmacologia
Córtex Cerebral/irrigação sanguínea
Córtex Cerebral/fisiopatologia
Di-Hidroergotamina/farmacologia
Modelos Animais de Doenças
Avaliação Pré-Clínica de Medicamentos
Dura-Máter/efeitos dos fármacos
Dura-Máter/metabolismo
Masculino
Camundongos Endogâmicos C57BL
Prazosina/farmacologia
RNA Mensageiro/metabolismo
Distribuição Aleatória
Ratos Sprague-Dawley
Fatores de Tempo
Vasoconstritores/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents); 0 (Pyrrolidines); 0 (RNA, Messenger); 0 (Serotonin Receptor Agonists); 0 (Tryptamines); 0 (Vasoconstrictor Agents); 22QOO9B8KI (eletriptan); 436O5HM03C (Dihydroergotamine); XM03YJ541D (Prazosin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161107
[St] Status:MEDLINE


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[PMID]:27837002
[Au] Autor:Robbins NM; Ito H; Scheinman MM; Goadsby PJ
[Ad] Endereço:From the Department of Neurology (N.M.R.), Dartmouth-Hitchcock Medical Center, Lebanon, NH; Section of Cardiac Electrophysiology, Division of Cardiology (H.I., M.M.S.), and Department of Neurology (P.J.G.), University of California, San Francisco; and NIHR-Wellcome Trust King's Clinical Research Fac
[Ti] Título:Safety of domperidone in treating nausea associated with dihydroergotamine infusion and headache.
[So] Source:Neurology;87(24):2522-2526, 2016 Dec 13.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the safety of domperidone in the treatment of nausea associated with dihydroergotamine (DHE) infusion and headache. METHODS: We audited our use of domperidone for the inpatient management of nausea, focusing on known safety concerns, particularly potential cardiac arrhythmias. RESULTS: We reviewed 103 consecutive admissions of 90 patients admitted for IV DHE by infusion. Most admissions were to treat chronic migraine with (n = 53) or without (n = 46) aura. Domperidone was administered in 85 of 103 encounters and was well-tolerated at doses up to 80 mg/d. A significant side effect, akathisia, was observed in one patient. Baseline ECG with corrected QT interval (QTc) was obtained on all patients. Repeat ECG after domperidone was obtained in 21 patients, whose baseline characteristics did not differ from the group as a whole. ECG was interpreted blindly by a cardiac electrophysiologist. QTc did not differ before and after domperidone administration (Wilcoxon signed-rank test, median [interquartile range] 435.0 [410.5-453.0] at admission and 427.0 [399.0-452.5] after domperidone; p = 0.15). In combination with other antiemetics, domperidone was effective in treating nausea such that no patients had refractory nausea severe enough to limit DHE dose. CONCLUSIONS: This retrospective audit demonstrates that domperidone is safe in the treatment of nausea associated with inpatient DHE infusion and headache. While larger prospective trials are necessary to confirm these results and assess efficacy, current evidence and clinical experience suggests that domperidone is safe and useful for nausea and headache management. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with headache undergoing DHE infusion, domperidone is safe and effective in the treatment of nausea.
[Mh] Termos MeSH primário: Antieméticos/uso terapêutico
Di-Hidroergotamina/uso terapêutico
Domperidona/uso terapêutico
Cefaleia/tratamento farmacológico
Transtornos de Enxaqueca/tratamento farmacológico
Náusea/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Antieméticos/administração & dosagem
Antieméticos/efeitos adversos
Di-Hidroergotamina/administração & dosagem
Domperidona/administração & dosagem
Domperidona/efeitos adversos
Feminino
Cefaleia/induzido quimicamente
Seres Humanos
Masculino
Meia-Idade
Náusea/induzido quimicamente
Estudos Prospectivos
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiemetics); 436O5HM03C (Dihydroergotamine); 5587267Z69 (Domperidone)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170518
[Lr] Data última revisão:
170518
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161113
[St] Status:MEDLINE


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[PMID]:27754915
[Au] Autor:Woldeamanuel YW; O'Hare M; DeSouza DD; Cowan RP
[Ad] Endereço:From the Stanford Headache and Facial Pain Program, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, CA. ywoldeam@stanford.edu.
[Ti] Título:Journal Club: Exacerbation of headache during dihydroergotamine for chronic migraine does not alter outcome.
[So] Source:Neurology;87(16):e196-e198, 2016 Oct 18.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Transient headache exacerbation during IV dihydroergotamine (DHE) therapy of migraine may prompt clinicians to prematurely discontinue DHE therapy, potentially depriving patients of the full benefit of DHE infusion. In a recent Neurology® article, Eller et al. evaluated whether or not worsening headache during DHE infusion was associated with suboptimal medium-term headache outcomes.
[Mh] Termos MeSH primário: Analgésicos não Entorpecentes
Di-Hidroergotamina
[Mh] Termos MeSH secundário: Cefaleia
Seres Humanos
Transtornos de Enxaqueca
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 436O5HM03C (Dihydroergotamine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161019
[St] Status:MEDLINE


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[PMID]:27634627
[Au] Autor:Sheridan DC; Meckler GD
[Ad] Endereço:Department of Emergency Medicine, Oregon Health & Science University, Portland, OR. Electronic address: sheridda@ohsu.edu.
[Ti] Título:Inpatient Pediatric Migraine Treatment: Does Choice of Abortive Therapy Affect Length of Stay?
[So] Source:J Pediatr;179:211-215, 2016 Dec.
[Is] ISSN:1097-6833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe the inpatient management of pediatric migraine and the association between specific medications and hospital length of stay (LOS). STUDY DESIGN: Historical cohort study review of patients age <19 years of age admitted to a single tertiary care children's hospital between 2010 and 2015 for treatment of migraine headache. RESULTS: The cohort consisted of 58 encounters with an average patient age of 14.3 years (SD 3.2 years) with a female predominance (62%). The mean number of inpatient medications received by patients was 3 (range 1-7), with dopamine antagonists and dihydroergotamine used most commonly (67% and 59% of encounters, respectively). The average LOS was 56 hours (95% CI 48.2-63.2) and did not vary by medication received, although patients who received an opioid had a significantly longer LOS (79.2 vs 47.9 hours respectively; P < .001). CONCLUSIONS: Children admitted to the hospital for treatment of migraine headache frequently require a large number of medications over an average hospital LOS of more than 2 days without apparent differences based on medication received other than prolonged stays for subjects who received opioids.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/uso terapêutico
Di-Hidroergotamina/uso terapêutico
Antagonistas de Dopamina/uso terapêutico
Hospitalização
Tempo de Internação/estatística & dados numéricos
Transtornos de Enxaqueca/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Dopamine Antagonists); 436O5HM03C (Dihydroergotamine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160917
[St] Status:MEDLINE


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[PMID]:27629088
[Au] Autor:Chou DE; Tso AR; Goadsby PJ
[Ad] Endereço:From the Headache Center (D.E.C.), Department of Neurology, Columbia University Medical Center, New York, NY; Headache Group (D.E.C., P.J.G.), Department of Neurology, University of California, San Francisco; and Headache Group (A.R.T., P.J.G.), Basic & Clinical Neuroscience, and NIHR-Wellcome Trust King's Clinical Research Facility, King's College London, UK.
[Ti] Título:Aprepitant for the management of nausea with inpatient IV dihydroergotamine.
[So] Source:Neurology;87(15):1613-1616, 2016 Oct 11.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the efficacy and tolerability of oral aprepitant, a substance P/neurokinin A receptor antagonist, in controlling nausea associated with IV dihydroergotamine (DHE) administered for medically refractory migrainous headache in patients not responding to standard antiemetics or with a history of uncontrolled nausea with DHE. METHODS: This was a retrospective chart review of prospectively collected hourly diary data and clinical notes of patients hospitalized between 2011 and 2015 for inpatient treatment with DHE. Patients were classified using the International Classification of Headache Disorders, 3rd edition (beta version). Peak and average daily nausea scores from hourly diaries, or daily entries of notes, and concurrent antiemetic use were collected and tabulated. RESULTS: Seventy-four patients, of whom 24 had daily diaries, with chronic migraine with or without aura, with or without medication overuse, or new daily persistent headache of a migrainous type, were identified. In 36 of 57 cases in which aprepitant was administered during hospitalization, there was a 50% reduction in the average daily number of as-needed antinausea medications. Of 57 patients, 52 reported that the addition of aprepitant improved nausea. Among 21 of 24 patients with hourly diary data, nausea scores were reduced and in all 12 with vomiting there was cessation of emesis after aprepitant was added. Aprepitant was well tolerated with no treatment emergent adverse events. CONCLUSIONS: Aprepitant can be effective in the treatment of refractory DHE-induced nausea and emesis. Given the broader issue of troublesome nausea and vomiting in acute presentations of migraine, general neurologists may consider what place aprepitant has in the management of such patients. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with medically refractory migraine receiving IV DHE, oral aprepitant reduces nausea.
[Mh] Termos MeSH primário: Analgésicos não Entorpecentes/efeitos adversos
Antieméticos/uso terapêutico
Di-Hidroergotamina/efeitos adversos
Morfolinas/uso terapêutico
Náusea/tratamento farmacológico
Náusea/etiologia
[Mh] Termos MeSH secundário: Administração Intravenosa
Administração Oral
Analgésicos não Entorpecentes/administração & dosagem
Di-Hidroergotamina/administração & dosagem
Seres Humanos
Pacientes Internados
Transtornos de Enxaqueca/tratamento farmacológico
Estudos Prospectivos
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 0 (Antiemetics); 0 (Morpholines); 1NF15YR6UY (aprepitant); 436O5HM03C (Dihydroergotamine)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160916
[St] Status:MEDLINE


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[PMID]:27595607
[Au] Autor:Bekan G; Tfelt-Hansen P
[Ad] Endereço:Department of Neurology, North Zealand Hospital in Hillerød, Hillerød, Denmark.
[Ti] Título:Is the Generally Held View That Intravenous Dihydroergotamine Is Effective in Migraine Based on Wrong "General Consensus" of One Trial? A Critical Review of the Trial and Subsequent Quotations.
[So] Source:Headache;56(9):1482-1491, 2016 Oct.
[Is] ISSN:1526-4610
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The claim that parenteral dihydroergotamine (DHE) is effective in migraine is based on one randomized, placebo-controlled, crossover trial from 1986. The aim of this review was to critically evaluate the original article. It was also found to be of interest to review quotes concerning the results in the more than 100 articles subsequently referring to the article. METHODS: The correctness of the stated effect of intravenous DHE in the randomized clinical trial (RCT) was first critically evaluated. Then, Google Scholar was searched for references to the article and these references were classified as to whether they judged the reported RCT as positive or negative. RESULTS: The design of the RCT, with a crossover within one migraine attack, only allows evaluation of the results for the first period and the effect of DHE and placebo were quite comparable. About 151 references were found for the article in Google scholar. Among the 95 articles with a judgment on the efficacy of intravenous DHE in the RCT, 90 stated that DHE was effective or likely effective whereas only 5 articles stated that DHE was ineffective. CONCLUSIONS: Despite a "negative" RCT, authors of subsequent articles on the efficacy of parenteral DHE overwhelmingly reported this RCT as "positive." This is probably due to the fact that the authors concluded in the abstract that DHE is effective, and to a kind of "wrong general consensus."
[Mh] Termos MeSH primário: Analgésicos não Entorpecentes/administração & dosagem
Di-Hidroergotamina/administração & dosagem
Transtornos de Enxaqueca/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Intravenosa
Seres Humanos
Ensaios Clínicos Controlados Aleatórios como Assunto/métodos
Projetos de Pesquisa
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 436O5HM03C (Dihydroergotamine)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160907
[St] Status:MEDLINE
[do] DOI:10.1111/head.12904


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[PMID]:27485816
[Au] Autor:Bauermeister A; Aguiar FA; Marques LM; Malta JD; Barros F; Callejon DR; de Oliveira AR; Lopes NP
[Ad] Endereço:Núcleo de Pesquisa em Produtos Naturais e Sintéticos (NPPNS), Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
[Ti] Título:In Vitro Metabolism Evaluation of the Ergot Alkaloid Dihydroergotamine: Application of Microsomal and Biomimetic Oxidative Model.
[So] Source:Planta Med;82(15):1368-1373, 2016 Oct.
[Is] ISSN:1439-0221
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Dihydroergotamine is a semisynthetic natural product derived from ergotamine, an ergot alkaloid. It is used to treat migraines, a neurological disease characterized by recurrent moderate to severe headaches. In this work, the metabolism of dihydroergotamine was evaluated in a biomimetic phase I reaction, aiming to verify all possible formed metabolites. Dihydroergotamine was submitted to an metabolism assay using rat liver microsomes, and the metabolites were analyzed by HPLC-MS/MS. The biomimetic reactions were performed with Jacobsen catalyst for scaling up production of oxidized metabolites. Two hydroxylated metabolites were isolated and characterized by MS/MS and H NMR analysis.
[Mh] Termos MeSH primário: Di-Hidroergotamina/metabolismo
Di-Hidroergotamina/farmacocinética
Microssomos Hepáticos/metabolismo
[Mh] Termos MeSH secundário: Animais
Clorobenzoatos/metabolismo
Cromatografia Líquida de Alta Pressão
Seres Humanos
Hidroxilação
Inativação Metabólica
Espectroscopia de Ressonância Magnética
Masculino
Microssomos Hepáticos/efeitos dos fármacos
Oxirredução
Ratos Wistar
Espectrometria de Massas em Tandem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chlorobenzoates); 436O5HM03C (Dihydroergotamine); G203D4H1RB (3-chloroperbenzoic acid)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160804
[St] Status:MEDLINE


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[PMID]:27416108
[Au] Autor:Chua AL; Silberstein S
[Ad] Endereço:a Jefferson Headache Center , Thomas Jefferson University , Philadelphia , PA , USA.
[Ti] Título:Inhaled drug therapy development for the treatment of migraine.
[So] Source:Expert Opin Pharmacother;17(13):1733-43, 2016 Sep.
[Is] ISSN:1744-7666
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The inhalation of substances, both medicinally and recreationally, is a commonly used method of drug administration but has been underutilized in the treatment of neurologic disorders such as migraine. Three drugs have been studied as potential inhalable treatments for acute migraine: dihydroergotamine (MAP0004), prochlorperazine (Staccato prochlorperazine), and loxapine (Staccato loxapine). AREAS COVERED: This review discusses the available literature describing the pharmacokinetics, tolerability and efficacy of MAP0004, Staccato prochlorperazine and Staccato loxapine, including data from Phase II and Phase III clinical trials. EXPERT OPINION: Inhaled DHE offers rapid absorption with a pharmacokinetic profile similar to IV administration. Improved side effect profile results from more selective binding at antimigraine serotonergic receptors 5-HT1B and 5-HT1D. Inhaled prochlorperazine is rapidly absorbed and resulted in statistically significant migraine pain relief at 2 hours compared to placebo but is not currently being pursued by the manufacturer as a potential migraine abortive. Inhaled loxapine is also rapidly absorbed into systemic circulation but Phase IIb trials did not show statistically improved pain relief or pain freedom compared to placebo. MAP0004 will likely provide a good alternative to patients seeking rapid relief without the need for injection or other invasive routes.
[Mh] Termos MeSH primário: Di-Hidroergotamina/administração & dosagem
Loxapina/administração & dosagem
Transtornos de Enxaqueca/tratamento farmacológico
Proclorperazina/administração & dosagem
[Mh] Termos MeSH secundário: Administração por Inalação
Animais
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
436O5HM03C (Dihydroergotamine); LER583670J (Loxapine); YHP6YLT61T (Prochlorperazine)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160715
[St] Status:MEDLINE
[do] DOI:10.1080/14656566.2016.1203901


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[PMID]:27234268
[Au] Autor:Schankin CJ; Maniyar FH; Seo Y; Kori S; Eller M; Chou DE; Blecha J; Murphy ST; Hawkins RA; Sprenger T; VanBrocklin HF; Goadsby PJ
[Ad] Endereço:1 Headache Group, Department of Neurology, University of California San Francisco, San Francisco, CA, USA 3 Department of Neurology, University Hospital Bern - Inselspital, University of Bern, Bern, Switzerland 4 Headache Group, NIHR-Wellcome Trust, King's Clinical Research Facility, King's College
[Ti] Título:Ictal lack of binding to brain parenchyma suggests integrity of the blood-brain barrier for 11C-dihydroergotamine during glyceryl trinitrate-induced migraine.
[So] Source:Brain;139(Pt 7):1994-2001, 2016 Jul.
[Is] ISSN:1460-2156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:SEE DREIER DOI 101093/AWW112 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: For many decades a breakdown of the blood-brain barrier has been postulated to occur in migraine. Hypothetically this would facilitate access of medications, such as dihydroergotamine or triptans, to the brain despite physical properties otherwise restricting their entry. We studied the permeability of the blood-brain barrier in six migraineurs and six control subjects at rest and during acute glyceryl trinitrate-induced migraine attacks using positron emission tomography with the novel radioligand (11)C-dihydroergotamine, which is chemically identical to pharmacologically active dihydroergotamine. The influx rate constant Ki, average dynamic image and time activity curve were assessed using arterial blood sampling and served as measures for receptor binding and thus blood-brain barrier penetration. At rest, there was binding of (11)C-dihydroergotamine in the choroid plexus, pituitary gland, and venous sinuses as expected from the pharmacology of dihydroergotamine. However, there was no binding to the brain parenchyma, including the hippocampus, the area with the highest density of the highest-affinity dihydroergotamine receptors, and the raphe nuclei, a postulated brainstem site of action during migraine, suggesting that dihydroergotamine is not able to cross the blood-brain barrier. This binding pattern was identical in migraineurs during glyceryl trinitrate-induced migraine attacks as well as in matched control subjects. We conclude that (11)C-dihydroergotamine is unable to cross the blood-brain barrier interictally or ictally demonstrating that the blood-brain barrier remains tight for dihydroergotamine during acute glyceryl trinitrate-induced migraine attacks.
[Mh] Termos MeSH primário: Barreira Hematoencefálica
Di-Hidroergotamina/metabolismo
Transtornos de Enxaqueca
Nitroglicerina/farmacologia
Tomografia por Emissão de Pósitrons/métodos
Vasoconstritores/metabolismo
Vasodilatadores/farmacologia
[Mh] Termos MeSH secundário: Adulto
Barreira Hematoencefálica/diagnóstico por imagem
Barreira Hematoencefálica/metabolismo
Feminino
Seres Humanos
Masculino
Meia-Idade
Transtornos de Enxaqueca/diagnóstico por imagem
Transtornos de Enxaqueca/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vasoconstrictor Agents); 0 (Vasodilator Agents); 436O5HM03C (Dihydroergotamine); G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170510
[Lr] Data última revisão:
170510
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160529
[St] Status:MEDLINE
[do] DOI:10.1093/brain/aww096



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