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Migraine: diagnosis and treatment
Published in Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby, Headache in Clinical Practice, 2018
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby
Treatment should be tailored to the attack and to the individual in whom it occurs. Determine the history of treatment, both prescription and over-the-counter, assessing both successes and failures. Be aware of all prescription and over-the-counter drugs that the patient is using, and assess the presence and risk for medication overuse. Acute headache medication overuse often causes treatment failure. Patient should be stratified primarily by severity and disability and treated with the medications most likely to be effective for that attack, taking into account the drug’s efficacy, safety, and side-effects.
Practice Organization and Management
Published in John Fry, Nat Yuen, Principles and Practice of Primary Care and Family Medicine: Asia-Pacific Perspectives, 2018
The cons are:without proper control of pharmacies, patients can obtain almost any medicine without prescription. Thus, if patients know the names, they can obtain drugs without doctors’ prescriptions. This leads to the danger of inappropriate treatment from lack of medical follow-upit is essential to have effective control of retail pharmacy practices and adequate patient education on the utilization of medication, particularly of over-the-counter drugs. This will avoid untoward complications resulting from self-medication if drug names are known.
Integrated Medical Biology
Published in W. John Diamond, The Clinical Practice of Complementary, Alternative, and Western Medicine, 2017
The concept of cure has been dealt with to some extent; however, wellness and health have never been adequately defined in modern medicine. The absence of disease does not mean wellness or health. There are many people walking around who have no disease but are certainly not well. Growing numbers of people lack vitality and suffer from a host of “normal” complaints such as allergies, headaches, lack of energy or excessive fatigue, indigestion, heartburn, constipation, restless sleep, or dysmenorrhea and PMS, along with a variety of emotional states ranging from mild depression to mood swings and anxiety. They are in a state of “vertical ill health.” They are not sick enough to lie down (“horizontal ill health”) and yet consider themselves normal because most of the people they know are equally unhealthy. They rely on a barrage of antihistamines, antiinflammatories, analgesics, HI-blockers, antacids, soporifics, laxatives, antidepressants, and tranquilizers to maintain adequate daily homeodynamic balance. The side effects that they develop from these mostly over-the-counter drugs only add to their problems.
Effect of quercetin on the pharmacokinetics of selexipag and its active metabolite in beagles
Published in Pharmaceutical Biology, 2022
Shun-bin Luo, Er-min Gu, Yu-ao Chen, Shi-chen Zhou, Chen Fan, Ren-ai Xu
It is widely believed that the phytochemicals derived from natural products are usually safe. However, people hardly realise that it may lead to serious clinically significant interactions when combined with prescription or over-the-counter drugs. Quercetin used for more than 160 years is a naturally polar auxin transport inhibitor (Fischer et al. 1997). Some researchers have reported that although cytochrome P450 family 1 subfamily A polypeptide 1 (CYP1A1), cytochrome P450 family 2 subfamily A polypeptide 6 (CYP2A6), and cytochrome P450 family 2 subfamily E polypeptide 1 (CYP2E1) are not affected by the quercetin, quercetin has the potential to inhibit CYP2C8 and CYP3A4 (Chandrasekaran et al. 1978; Elbarbry et al. 2019). The in vitro study has demonstrated that selexipag is hydrolysed by CYP3A4 and CYP2C8 enzymes to the main active metabolite, ACT-333679 (Gnerre et al. 2018). However, ACT-333679 is not only metabolised by CYP3A4 and CYP2C8 but also metabolised by other ways such as the uridine 5″-diphosphoglucuronosyltransferase (UGT) enzymes, etc. (Gnerre et al. 2018).
Exacerbation of diclofenac-induced gastroenterohepatic damage by concomitant exposure to sodium fluoride in rats: protective role of luteolin
Published in Drug and Chemical Toxicology, 2022
Akinleye S. Akinrinde, Kehinde O. Soetan, Monsuru O. Tijani
Nonsteroidal anti-inflammatory drugs (NSAID) e.g., diclofenac, indomethacin, ibuprofen, etc., are widely available over-the-counter drugs for the treatment of pain, inflammation, and fever (Wallace 2016). They are, however, well known for their toxic side effects of gastrointestinal ulceration and bleeding (Chatterjee and Bandyopadhyay 2014). NSAIDs are known to block the synthesis of muco-protective prostaglandins by inhibiting the expression of both constitutive (COX-1) and inducible (COX-2) cyclooxygenase enzymes. Diclofenac (DIC) is a lipophilic NSAID used in the treatment of pain of musculoskeletal disorders, rheumatoid arthritis, and osteoarthritis (Tieppo Francio et al. 2017). Like most other NSAIDs, high doses of DIC present side effects of enteropathy, gastrointestinal ulceration, and bleeding amongst other effects. Studies have shown that DIC administration produces acute erosions and immediate gastroduodenal damage within hours of ingestion (Hawkins and Hanks 2000). The mechanisms of DIC toxicity has been reported to involve increased oxidative stress and inflammation, as well as mitochondrial dysfunction (Galati et al.2002).
No difference in antidepressant prescription in rheumatoid arthritis and controls. Results from a population-based, matched inception cohort
Published in Scandinavian Journal of Rheumatology, 2022
JK Pedersen, K Andersen, AJ Svendsen, K Hørslev-Petersen
The Danish National Prescription Register (16) contains complete nationwide data on individual-level redeemed prescriptions at community pharmacies from 1995 onwards. In Denmark, the tax-financed public health insurance covers all inhabitants with varying levels of co-payment for prescription drugs. General practitioners prescribe most antidepressants (17), which are not over-the-counter drugs. In 2016, about 7.2% of the Danish population over the age of 15 years redeemed at least one antidepressant prescription (18), and in a survey of middle-aged individuals from 2000, the 1 year period prevalence for treatment with antidepressants for at least 6 months was 3.1% (19). The prescription register contains electronic and non-electronic prescriptions, and in 2015, the fraction of electronic prescriptions was about 86% (20). Since 2004, it has been obligatory to provide an indication for prescribing, and a list of approved indications has been added to the register. If the prescriber chooses to add free text or modify an approved indication, the indication is missing (21).