Migraines

Among the indole derivatives which have found use as drugs are indo-methacin, one of the first non-steroidal anti-inflammatory agentsfll], sumatriptan, which is used in the treatment of migraine headaches[12] and pindolol[13], one of the p-adrenergic blockers. 

The aerosol container has enjoyed commercial success ia a wide variety of product categories. Insecticide aerosols were iatroduced ia the late 1940s. Additional commodities, including shave foams, hair sprays, antiperspirants, deodorants, paints, spray starch, colognes, perfumes, whipped cream, and automotive products, followed ia the 1950s. Mediciaal metered-dose aerosol products have also been developed for use ia the treatment of asthma, migraine headaches, and angiaa. 

Destmction of the aluminum complex with ammonia then permits hydrocarbon extraction of the alkaloid. The alkaloid is subsequently both isolated and used as its tartrate salt. This nonnarcotic dmg, for which tolerance may develop, is frequently used orally with caffeine (16) for treatment of migraine it acts to constrict cerebral blood vessels, thus reducing blood flow to the brain. 

Patients receiving monoamine oxidase inhibitors (MAOI) as antidepressant therapy have been especially subject to the hypertensive effects of vasoactive amines (52). These dietary amines have also been impHcated as causative agents ia migraine. Other aaturaHy occurring alkaloids (qv) have been recognized for centuries as possessing neurological stimulant and depressant properties. 

The lungs large, permeable surface makes systemic deUvery possible. For example, an inhaler deUvers 360 )Tg per dose of aerosolized ergotamine tartrate [379-79-3] for migraine (54), and inhalant systems deUver anesthetic gases. Research is under way on the systemic deUvery of proteins and peptides through the lungs (57,58). 

Imitrex (Sumatriptan) 82 is the first selective 5-HTid agonist developed by Glaxo for the treatment of migraine. The synthesis of Imitrex has been carried out by several different routes all of which involved a Fischer indolization reaction as the key step. Outlined below is one of the synthetic routes. 

Antidepressants are used in neuropathic pain and migraine prophylaxis. Tricyclics require monitoring of plasma drug concentrations to achieve optimal effect... 

Various pain states (e.g. headache, toothache and migraine), primarily pathophysiological inflammatory pain, e.g. rheumatic pain and pain caused by bone metastases... 

Mutation in the neuronal Cav2.1 channel is associated with familial hemiplegic migraine and episodic ataxia in humans. Deletion of the Cav2.1, Cav2.2 and Cav2.3 gene is compatible with life accompanied by a variety of central and peripheral defects. 

These dm are primarily used in the treatment of hypertension (see the Summary Drug Table Adrenergic Blocking Drugs also see Chap. 39) and certain cardiac arrhythmias (abnormal rhythm of the heart), such as ventricular arrhythmias or supraventricular tachycardia They are used to prevent reinfarction in patients with a recent myocardial infarction (1—4 weeks after MI). Some of these dm have additional uses, such as the use of propranolol for migraine headaches and nadolol for angina pectoris. 

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