Dvpharm.com – Pharmacy Information

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HEADACHES: CAUSES, SIGNS AND DRUGS
A serious underlying disease, such as a brain tumor, may cause the headache in patients complaining of skull pains. Here are the warning signs of severe problems, as cited by Dr. Lipton:
• Sudden onset of the worst headache could mean you are bleeding in the brain – a stroke. Go immediately to the hospital emergency room.
• Headache with fever and a stiff neck could mean meningitis. The symptoms may signal bleeding into the brain.
• If strong headaches replace weak ones over weeks or months, see your physician.
• Red eyes or blurring vision with a headache point to glaucoma, high pressure in the eye. Untreated, you risk blindness.
• A seizure (a fit) or a new type of headache, at any age but particularly after 55, is a good reason to consult your doctor.
As scientists unravel the causes of various headaches, new treatments are being devised, though exactly why some of them work is often unclear.
Rodney Fritz, news director and morning anchor of WMJX-FM, a radio station in Boston, endured cluster headaches every August for 5 years. “The third year was the worst ever,” he says. “It was like someone sticking a hot poker in my eye. I would pace. I wore a path in the rug. Tears were coming from my eye.”
Mr. Fritz went to the headache center at Faulkner Hospital in Boston, where they gave him ergotamine and verapamil, a drug that lowers high blood pressure. They also gave him pure oxygen to breathe. The treatments helped ease his pain.
Dr. Egilius L. H. Spierings, director of the headache center at Faulkner, has tested verapamil on 48 cluster-headache patients and says two-thirds improved greatly.
Dr. Lipton categorizes headache drugs this way:
• Abortive – These stop headaches. They include ergotamine and some of the new non-steroidal anti-inflammatory chemicals.
• Prophylactic – These prevent headaches. They include antidepressants, beta-blockers, and calcium channel-blockers. These chemicals act on tiny muscles in the arteries. The last two usually are used to treat high blood pressure. Verapamil is a calcium channel-blocker. Chiefly used for cluster headaches are methysergide, prednisone (a type of cortisone), and lithium, a drug usually prescribed for manic depression.
• Symptomatic – These drugs reduce the pain and other headache symptoms. They include aspirin, codeine, and other painkillers. But sometimes these drugs make the headache worse. Should you get rebound headaches in the morning, your doctor might prescribe Compazine to reduce the nausea of migraine.
At the General Medical Center in Akron, Ohio, Dr. James Dougherty injected patients with Compazine. He says it stopped the cluster headaches without the aid of other painkillers.
Headaches also often respond to non-drug treatments, such as relaxation therapy, meditation, hypnosis, and biofeedback. If chronic stress on the job or at home triggers headaches, it may be important to change your job or adopt a new lifestyle. Psychological counseling may help.
By doing more research on the underlying causes, scientists quite possibly will find new and effective ways to stop, prevent, or ease the pain of headaches.
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Other names: Null
LEUKOTRIENES, THROMBOXANE AND PROSTACYCLIN
Like prostaglandins, leukotrienes have an almost incredible variety of effects, some highly desirable and some harmful. Each cell produces a specific pattern of prostaglandins and leukotrienes. There are over 50 types of prostaglandins and leukotrienes and related molecules, and there are new ones being discovered each year.
Leukotrienes are not part of the picture of the conversion of evening primrose oil to its metabolites because dihomo-gammalinolenic acid (step 3 in the conversion process) cannot give rise to leukotrienes. However, evening primrose oil does have a role to play against the harmful leukotrienes.
Arachidonic acid gives rise to leukotrienes which are very inflammatory. In fact, whenever any kind of inflammation is happening in the body, the products of arachidonic acid are found in abundance. These other products are thromboxane A2 and 2 series prostaglandins such as PG F2alpha. These have undesirable effects such as promotion of vasospasm, thrombosis and inflammation.
However, some of the prostaglandins which arachidonic acid leads to, such as prostacyclin (PG12), do have desirable effects such as the inhibition of platelet aggregation and dilation of blood vessels.
Evening primrose oil works as an anti-inflammatory agent because PGEl works in a similar way to steroid drugs, by blocking the mobilization of arachidonic acid. Recently, American scientists have also found that it blocks the formation of certain harmful leukotrienes from arachidonic acid. Fish oils, eicosapentaenoic acid and its derivatives, seem to compete with arachidonic acid and so prevent the conversion of arachidonic acid to inflammatory metabolites.
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