Standards of the International Headache Society (International Headache against)
Much of this recent success stems from the work that has been made in studies on headache. In 1988, the proposed International Headache Society classification and diagnostic criteria for headache disorders and pain in the face. I participated in a committee that designed the classification. In this international uniform rules were developed to diagnose migraine and other headache disorders. Long ago, the diagnostic standards for classifying headaches were not as accurate. The revised classification proposed by medical scientists worldwide working with patients suffering from headache enabled physicians to study pharmacological agents (drugs) in similar patients. The symptoms of patients would have to meet diagnostic criteria, which allow doctors from different countries and speaking different languages could be included in research studies to similar patients who suffer the same disorder of migraine.
These standards allowed the diagnostic study of the efficacy and adverse effects of drugs on an international scale. During the past eleven years since the classification proposed we have witnessed the development of several new pharmacological agents, which are using other doctors and I to treat migraine. The drugs have been tested in many patients, and its effectiveness has been demonstrated successfully that meet scientific standards. By using these new diagnostic criteria, some drugs previously used for other conditions also successfully demonstrate that they are effective for migraine. In addition, a compound counter designated as effective against migraine. We used the same standards of diagnosis in this research study and the counter analgesic, now in common use, has FDA approval for migraine with and without aura. (According to the classification of 1988, is known as classic migraine 'migraine with aura "and common migraine as" migraine without aura. ")
Pharmacological Advances
What new agents are available for the migraine treatments and migraine prevention? What can we expect in the future? Many compounds have proven effective in scientific studies, but only some have received government support. The FDA approval is based on having sufficient number of controlled studies and a consensus of informed people who have agreed on a particular drug could be marketed for a specific indication (eg, to treat migraine).
Triptans
The most recent and novel drugs, a class called triptans, are a major advance for treatment. The first was sumatriptan, which was available in injectable form in 1992, followed by a presentation on tablet in 1995 and as intranasal spray in 1997. Many patients miraculous because this compound relieves migraine pain and associated symptoms, however, that the aura or other warning symptoms do not respond. Triptans interact with specific receptors of serotonin in the brain and blood vessels, known to be affected during a migraine attack. Often, patients can return to normal activities without major discomfort between 30 and 60 minutes after using a triptan. The injection of sumatriptan works faster, but the nasal spray and tablets work somewhat slower, but more convenient for many people affected.
In the early 1990s also began work on the next generation of triptans. The Naratriptan lasts longer in the body than sumatriptan and acts more slowly, features that might be helpful for headaches of long duration. The Zolmitriptan works faster and crosses the "blood-brain barrier." Patients report a continued effectiveness with frequent use. The newer triptan that has been introduced is the Rizatriptan, available in oral form and fast-dissolving tablet presentation. The Rizatriptan has also shown continued effectiveness and improving nausea and sensitivity to light and noise associated with accompanying migraine.
Triptans are powerful agents and their use requires a prescription. They are contraindicated for certain types of heart disease and people with high blood pressure.
No comments:
Post a Comment