Headache clinical efficacy

CALCIUM CHANNEL BLOCKERS IMATINIB t plasma concentrations of imatinib when is co-administered with dilti-azem, nifedipine or verapamil, t risk of toxicity (e.g. abdominal pain, constipation and dyspnoea) and of neurotoxicity (e.g. taste disturbances, dizziness, headache, paraesthesias and peripheral neuropathy) Due to inhibition of hepatic metabolism of imatinib by the CYP3A4 isoenzymes by diltiazem Monitor for clinical efficacy and for the signs of toxicity listed along with convulsions, confusion and signs of oedema (including pulmonary oedema). Monitor electrolytes and liver function, and for cardiotoxicity... 

Similar to the clinical efficacy of theophylline, side effects are also closely related to sernm concentrations. No critical side effects have been observed at sernm theophylline levels np to 20 pg/ml. However, transient comparatively slight side effects similar to those of caffeine, including nausea, vomiting, headache, diarrhea, and insomnia, occnr in some patients at theophylline sernm concentrations below 20 pg/ml. These side effects may be present in np to 50% of patients when serum concentrations of 10 to 20 pg/ml are rapidly achieved, bnt they are usually much less frequent when the initial dose is low and the hnal drng concentration is gradually achieved by increasing doses in intervals of at least 3 days. 

Susceptibility factor Age The efficacy and safety of ambrisentan in children with pulmonary hypertension have been studied in a retrospective cohort study [26 ]. A total of 38 patients received ambrisentan either as an add-on therapy to bosentan (23 children) or transition from bosentan (15 children). Five patients (13%) discontinued ambrisentan due to severe headache, lack of clinical efficacy or near syncope. Ten patients (26%) had side effects associated with ambrisentan treatment, including nasal congestion, headache and flushing. However, no patients had aminotransferase abnormalities and there were no deaths after initiation of ambrisentan during follow-up. 

Second-generation triptans (all except sumatriptan) have higher oral bioavailability and longer half-lives than oral sumatriptan, which could theoretically improve within-patient treatment consistency and reduce headache recurrence. However, comparative clinical trials are necessary to determine their relative efficacy. 

Priliximab (cM-T412) is an anti-CD4 chimeric monoclonal antibody that was evaluated in the clinic for the treatment of autoimmune diseases. Priliximab binds to CD4 on the surface of T cells and leads to a profound and sustained decrease in circulating CD4+ T cells decreased counts have been reported to be below normal levels at 18 and 30 months following single- and multiple-infusions.81 Similar findings were observed in preclinical studies in chimpanzees.82 The administration of priliximab was also associated with a cytokine-release syndrome that caused transient fever, myalgia, chills, headache, nausea, and/or hypotension that was accompanied by an increase in serum IL-6. Although evidence of efficacy was observed in clinical trials for CD, the... 

An excellent brief article on buprenorphine treatment has been provided by Taikato et al. (2005), which notes the common possible side-effects (headaches, nausea and vomiting, sweating, constipation, etc.) and drug interactions. The limited central depressant effect of buprenorphine may be compounded by alcohol and antidepressants, while the metabolism of buprenorphine can be enhanced by anticonvulsants, with therefore possibly reduced efficacy. There have been some case reports of liver toxicity from buprenorphine that is reversible if the medication is stopped (Herve et al. 2004), and often clinical guidelines will recommend that liver function tests are included in buprenorphine treatment, as they definitely should be with naltrexone. 

To reduce toxicity while maintaining therapeutic efficacy, more selective inhibitors of different isoforms of PDE4 were developed (eg, roflumilast, cilomilast, and tofimilast), particularly for the treatment of chronic obstructive pulmonary disease (COPD), but they were abandoned after clinical trials showed that their toxicities of nausea, headache, and diarrhea restricted dosing to subtherapeutic levels. A new generation of selective PDE4 inhibitors is now under development, but none seems close to approval for clinical use. 

---