Memantine for the Prevention of Primary Headache Disorders

2014 ◽  
Vol 48 (11) ◽  
pp. 1507-1511 ◽  
Author(s):  
Linda Huang ◽  
Michael Bocek ◽  
Joseph K. Jordan ◽  
Amy Heck Sheehan
Keyword(s):  
Chronic Migraine ◽  
English Language ◽  
Data Extraction ◽  
Primary Headache ◽  
Current Data ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Migraine Headaches ◽  
Study Selection ◽  
Refractory Chronic Migraine

Objective: To describe the current data evaluating the efficacy and safety of memantine for the prevention of primary headache disorders. Data Sources: A literature search using MEDLINE (1966-July 2014) and EMBASE (1973-July 2014) was conducted using the search terms memantine, headache, migraine, glutamate, and NMDA. References of identified articles were reviewed for additional, relevant citations. Study Selection and Data Extraction: All English-language articles dealing with the use of memantine for prevention of primary headache disorders were included. Data Synthesis: Data from several retrospective reports and 2 prospective clinical trials suggest that memantine may be a useful treatment option for the prevention of primary headache disorders. The majority of available literature focuses specifically on chronic migraine prevention in refractory patients who had failed multiple previous prophylactic therapies. In these patients, 10 to 20 mg of memantine daily reduced the frequency and intensity of migraine headaches and was generally well tolerated, with few adverse events. Data regarding the efficacy of memantine for other primary headache disorders such as chronic tension type and cluster headaches are limited. Conclusion: Although further studies evaluating the efficacy of memantine for prevention of primary headache disorders are warranted, memantine may be a reasonable option, used either as monotherapy or adjunctive therapy, in the refractory chronic migraine prophylaxis setting.

Role of Topical Oxymetazoline for Management of Erythematotelangiectatic Rosacea

2017 ◽  
Vol 52 (3) ◽  
pp. 263-267 ◽  
Author(s):  
Rebecca M. Hoover ◽  
John Erramouspe
Keyword(s):  
English Language ◽  
Human Subjects ◽  
Data Extraction ◽  
Drug Approval ◽  
Current Data ◽  
Patient Response ◽  
Study Selection ◽  
Cochrane Database ◽  
Drug Approval Process ◽  
Individual Patient Response

Objective: To review and summarize topical oxymetazoline’s pharmacology, pharmacokinetics, efficacy, safety, cost, and place in therapy for persistent redness associated with erythematotelangiectatic rosacea. Data Sources: Literature searches of MEDLINE (1975 to September 2017), International Pharmaceutical Abstracts (1975 to September 2017), and Cochrane Database (publications through September 2017) using the terms rosacea, persistent redness, α -agonist, and oxymetazoline. Study Selection and Data Extraction: Results were limited to studies of human subjects, English-language publications, and topical use of oxymetazoline. Relevant materials from government sources, industry, and reviews were also included. Data Synthesis: Data support the efficacy of oxymetazoline for persistent facial redness. Little study beyond clinical trials cited in the drug approval process has been conducted. Current data suggest that oxymetazoline is similar in safety and efficacy to brimonidine. Head-to-head comparisons of topical α-agonists for erythema caused by rosacea are needed. Conclusion: The topical α-agonist, oxymetazoline, is safe and effective for reducing persistent facial redness associated with erythematotelangiectatic subtype of rosacea. Health care practitioners selecting among treatments should consider not only the subtype of rosacea but also individual patient response, preference, and cost.

Headache

2016 ◽  
pp. 355-382
Author(s):  
Douglas J. Gelb
Keyword(s):  
Primary Headache ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Secondary Headache Disorders ◽  
Tacit Assumption ◽  
Migraine Headaches ◽  
Pathophysiologic Mechanisms

Headaches can occur independently of any other disease processes (primary headache disorders) or they can be associated with a wide variety of underlying neurologic and systemic conditions (secondary headache disorders). The pathophysiologic mechanisms are incompletely under- stood. Most research has focused on migraine headaches, with the tacit assumption that other headache syndromes, both primary and secondary, have similar mechanisms.

Use of Fish Oil to Prevent Coronary Angioplasty Restenosis

1992 ◽  
Vol 26 (12) ◽  
pp. 1541-1545 ◽  
Author(s):  
Vincent F. Mauro ◽  
Lawrence A. Frazee
Keyword(s):  
Eicosapentaenoic Acid ◽  
Fish Oil ◽  
English Language ◽  
Data Extraction ◽  
Current Data ◽  
Study Selection ◽  
Number Of Patients ◽  
Bibliographic Search ◽  
Definition Of ◽  
Key Terms

OBJECTIVE: To review the literature investigating the use of fish oil in preventing restenosis postangioplasty (RPA). DATA SOURCES: An Index Medicus and bibliographic search of the English-language literature pertaining to the use of fish oil in preventing RPA. The key terms used were fish oil, angioplasty, and eicosapentaenoic acid. STUDY SELECTION AND DATA EXTRACTION: The results of all trials, including abstracts, that were obtained are reviewed and critiqued. DATA SYNTHESIS: Restenosis of a coronary vessel at the site of angioplasty occurs 30–40 percent of the time. Because fish oil has been theorized to prevent atherosclerosis and because atherosclerotic-like processes are theorized to be involved in RPA restenosis, fish oil has been studied to determine whether it can prevent RPA. Results of such trials have been mixed. Some have observed a reduction in the number of patients with angiographic or clinical evidence of restenosis. Two trials have failed to observe such an effect. Reasons for the differences are unknown. Possible explanations include differences in study design, endpoint parameters, definition of restenosis, and dosing methods of the fish oil. Bleeding was not of significant concern in any of the trials, even when fish oil was combined with antiplatelet therapy. CONCLUSIONS: Fish oil may be considered for use in patients to prevent RPA. It probably should be continued for only six months following the procedure. Current data suggest that at least 3 g/d of eicosapentaenoic acid and 1 g/d of docosahexaenoic acid should be used. If possible, therapy should be started as soon as it is known that angioplasty will be performed or at least as soon as possible following the procedure. Many patients may not be able to tolerate fish oil because of its gastrointestinal effects.

scholarly journals Symptom-based clinical profiles in the classification of post-traumatic headache

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S28.2-S28
Author(s):  
Andrew H Ahn ◽  
Sylvia M Lucas
Keyword(s):  
Unmet Need ◽  
Clinical Manifestations ◽  
Primary Headache ◽  
Current Data ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Specific Outcome ◽  
Post Traumatic ◽  
Definition Of

There are currently no established therapies for post-traumatic headache (PTH). One key obstacle standing in the way of meeting this unmet need is the fundamental gap in our understanding of the clinical course and functional impact of PTH. In this presentation we examine the existing schema used to characterize the clinical characteristics of PTH, including the International Classification of Headache Disorders (ICHD), and find that they leave major unresolved questions about the diagnosis, classification, and measurement of the clinical impact of PTH. Specifically, current data suggest that the ICHD classification, which is based on the extent of brain injury and the duration of condition, have limited prognostic and treatment implications. There are several challenges to the classification of PTH, as the clinical manifestations of PTH do not map well to the primary headache disorders, and the definition of the continuous and chronic daily headache require further study. Importantly, the existing classification do not provide or imply specific outcome measures for PTH, again a fundamental roadblock to testing therapeutic hypotheses for PTH. We hypothesize that a symptom-based classification is needed to begin an examination of these unresolved questions, and to establish clinically relevant endpoints for research and clinical trials for effective therapies.

Can Valproate Prevent Migraine Headaches?

1997 ◽  
Vol 13 (4) ◽  
pp. 163-168
Author(s):  
Binh N Tran ◽  
Virginia S Vivian ◽  
Kelly J Burch
Keyword(s):  
English Language ◽  
Data Extraction ◽  
Historical Study ◽  
Channel Blockers ◽  
Medline Search ◽  
Transformed Migraine ◽  
Migraine Headaches ◽  
Study Selection ◽  
The Us ◽  
Receptor Blockers

Objective: To investigate the effectiveness of valproate in the prevention of migraine headaches. The drug has been approved by the FDA for migraine prophylaxis in addition to its primary use in seizure control. Data Sources: A MEDLINE search (1988–1995) of the English-language literature pertaining to the use of valproate for prophylaxis of migraine headaches was performed. Additional literature was obtained from reference lists of pertinent articles identified through the search. Study Selection and Data Extraction: All articles were considered for possible inclusion in the review. Pertinent information was selected for discussion. Data Synthesis: Results of five clinical studies carried out worldwide were reviewed: a historical study of 22 patients from Denmark and studies of 32 patients in Israel, 43 patients in Denmark, 75 patients in California, and 117 patients in the US. Eleven patients (50%) were free of headache in the first study. The number of migraine attacks decreased from 15.5 to 8.8 in the second study, whereas patients treated with valproate reported 3.5 days with migraine versus 6.1 for patients receiving placebo in the third study. Efficacy rates of 85% and 61% were seen for patients with frequent migraine and transformed migraine, respectively, in the fourth study, and 48% of patients treated with divalproex compared with 14% of patients receiving placebo showed at least a 50% reduction in migraine headache frequency in the fifth study. Conclusions: Approximately half of the patients were shown to experience roughly a 50% reduction in the number of migraine attacks or days with migraine headaches; thus, valproate appears to provide a therapeutic alternative for patients who do not respond to or cannot tolerate beta-receptor blockers, tricyclic antidepressants, or calcium-channel blockers for prophylaxis of migraine headaches.

scholarly journals Review of Ceftazidime-Avibactam, Meropenem-Vaborbactam, and Imipenem/Cilastatin-Relebactam to Target Klebsiella pneumoniae Carbapenemase-Producing Enterobacterales

2020 ◽  
Vol 36 (5) ◽  
pp. 202-210
Author(s):  
Dillon A. Hayden ◽  
Bryan P. White ◽  
Kiya K. Bennett
Keyword(s):  
Klebsiella Pneumoniae ◽  
English Language ◽  
Antimicrobial Agents ◽  
Product Information ◽  
Data Extraction ◽  
Global Scale ◽  
Current Data ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Ovid Medline ◽  
Study Selection

Objective: To provide a review of 3 novel antimicrobial agents—ceftazidime-avibactam, meropenem-vaborbactam, and imipenem/cilastatin-relebactam—regarding treatment of Klebsiella pneumoniae carbapenemase-producing Enterobacterales (KPC). Data Sources: A literature search of PubMed and OVID (MEDLINE) was performed up to March 2020 using the following search terms: Vabomere, meropenem-vaborbactam, vaborbactam, RPX7009, Klebsiella pneumoniae carbapenemase, KPC, carbapenem-resistant Enterobacteriaceae, CRE, relebactam, imipenem-relebactam, MK-7655, ceftazidime-avibactam. Abstracts from conferences, article bibliographies, and product information were also reviewed. Study Selection and Data Extraction: Articles were first screened by English language, then title, then abstract, and finally by review of the full article. Fifty-five clinical and preclinical studies were included. Data Synthesis: These 3 novel β-lactam/β-lactamase inhibitor combinations have shown considerable improvement in safety and efficacy as compared with traditional polymyxin-based combination therapy for the treatment of KPC infections. While meropenem-vaborbactam has not shown improved activity against Pseudomonas aeruginosa, it has shown decreased rates of resistance to KPC versus ceftazidime-avibactam. Conclusions: With increasing incidence of KPC infections on a global scale, pharmacists should be aware of the notable similarities and differences between these 3 agents, and the current data supporting their use. Pharmacists may want to consider meropenem-vaborbactam over ceftazidime-avibactam for KPC infections due to decreased likelihood of resistance.

Lead in Mineral or Multivitamin-Multimineral Products

2021 ◽  
pp. 106002802110233
Author(s):  
C. Michael White
Keyword(s):  
English Language ◽  
Data Extraction ◽  
The United States ◽  
Third Party ◽  
Reference Level ◽  
Study Selection ◽  
Pubmed Search ◽  
Zinc Supplements ◽  
Average Lead ◽  
Year 2000

Objective Assess the current daily interim reference level of lead and the amount contained in current mineral and multivitamin-multimineral (MVM) products. Data Sources PubMed search from 1980 to May 15, 2021, limited to the English language, via the search strategy ((mineral OR multivitamin OR calcium OR iron OR magnesium OR copper OR zinc OR chromium OR selenium) AND (heavy metals OR Pb OR lead)). Study Selection and Data Extraction Narrative review of studies assessing lead content in mineral or MVM products. Data Synthesis Products containing different calcium forms (dolomite, bone meal, natural carbonate) have historically had higher lead levels than others (refined carbonate, lactate, gluconate, acetate, sevelamer), but the gap has closed considerably since the year 2000. Although only limited assessments of magnesium and zinc supplements have been conducted, no alarming average lead amounts were found. MVM products assessed since 2007 had low median or mean lead concentrations. However, large interproduct differences exist, with many products having very little lead and some products having concerning amounts. Relevance to Patient Care and Clinical Practice It is difficult for pharmacists and consumers to know the amount of lead in an actual product unless it is tested in an independent third-party lab. The United States Pharmacopeia and NSF International will provide a seal on the products stating that the products have a low level of lead, but even so, children could receive more lead than the Food and Drug Administration’s Interim Reference Level. Conclusions The threat from lead exposure in mineral and MVM products have diminsihed considerably over time but some products can still have excessive amounts. Without third-party testing, it is difficult for clinicians and consumers to know which outlier products to avoid.

Recent Advances: Antiinfectives

1995 ◽  
Vol 29 (10) ◽  
pp. 1035-1040 ◽  
Author(s):  
Laurie L Briceland ◽  
John D Cleary ◽  
Courtney V Fletcher ◽  
Daniel P Healy ◽  
Charles A Peloquin
Keyword(s):  
Infectious Diseases ◽  
English Language ◽  
Data Extraction ◽  
Information Service ◽  
Ulcer Disease ◽  
Additional Information ◽  
Study Selection ◽  
Enterococcus Spp ◽  
Scientific Meetings ◽  
Clinically Significant

Objective: To update readers on the significant changes in infectious diseases pharmacotherapy. Data Sources: An Index Medians and Iowa Drug Information Service search (1993–1994) of English-language literature pertaining to the selected topic areas was performed. Additional information from abstracts presented at scientific meetings were identified by the authors. Study Selection and Data Extraction: All identified studies were screened and those judged relevant to the update were evaluated. Data Synthesis: New or clinically significant data since 1992 that related to peptic ulcer disease, microbial resistance (e.g., Enterococcus spp., Streptococcus pneumoniae, Mycobacterium tuberculosis, Candida albicans), immunomodulators, and AIDS were evaluated and compared with previous data. Conclusions: There have been several exciting and significant changes in infectious diseases pharmacotherapy evident from this review.

Pegfilgrastim-Induced Bone Pain: A Review on Incidence, Risk Factors, and Evidence-Based Management

2017 ◽  
Vol 51 (9) ◽  
pp. 797-803 ◽  
Author(s):  
Donald C. Moore ◽  
Annie E. Pellegrino
Keyword(s):  
Risk Factors ◽  
Bone Pain ◽  
English Language ◽  
Data Extraction ◽  
Treatment Modalities ◽  
Management Options ◽  
Data Synthesis ◽  
Pharmacological Management ◽  
Study Selection ◽  
Incidence Risk

Objective: To review the incidence, risk factors, and management of pegfilgrastim-induced bone pain (PIBP). Data Sources: PubMed was searched from 1980 to March 31, 2017, using the terms pegfilgrastim and bone pain. Study Selection and Data Extraction: English-language, human studies and reviews assessing the incidence, risk factors, and management of PIBP were incorporated. Data Synthesis: A total of 3 randomized, prospective studies and 2 retrospective studies evaluated pharmacological management of PIBP. Naproxen compared with placebo demonstrated a reduction in the degree, incidence, and duration of bone pain secondary to pegfilgrastim. Loratadine was not effective in reducing the incidence of bone pain prophylactically, but a retrospective study evaluating dual antihistamine blockade with loratadine and famotidine demonstrated a decreased incidence in bone pain when administered before pegfilgrastim. Conclusion: Naproxen is effective at managing PIBP. Although commonly used, antihistamines have a paucity of data supporting their use. Dose reductions of pegfilgrastim and opioids may also be potential management options; however, data supporting these treatment modalities are scarce.

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