Mirayiridzo kubva kuAHS / AAN
Kuchengetedza tsamba yepamusoro ndeyechimwe chinhu chikuru chedu migraineurs vanoita kuti tione kuti migraine yedu inokonzera chii. Nokunyatsocherechedza kuchengetedza nekudzivirira zvatinokonzera, tinotarisira kudzivisa kukanganisa migraine kurwisa. Asi, ngatiti tive nechokwadi, pasinei nekutangisa kunzvenga, vazhinji vanogadziriswa vanoramba vachida mushonga wezuva nezuva kudzivirira izvi zvinotyisa misoro.
Chii chinonzi Migraine Preventive Medication?
Mishonga inodzivirira inotorwa zuva roga roga kuti kuderedze nhamba, kuoma, uye nguva yekurwisa migraine, pamwe nekuderedza kuremara kunounzwa nemusoro wepamusoro. Iyo inowanzoshandiswa kune avo vanotambura nekusingaperi migraines , asi inogona kushandiswawo kune episodic migraineurs.
Mienzaniso yezviratidzo zvinogona kuitika (kunze kwekusagadzikana kwenguva refu) kwemishonga inodzivirira inosanganisira: kupesana kwekutora mishonga yekurapa uye / kana unhu husina kunaka hwehupenyu kana kushanda kwezuva nezuva. Nzira dzakawanda dzemigraine se hemiplegic migraine kana basilar migraine inogonawo kuva chiratidzo chekudzivirira mishonga.
IAmerican Headache Society (AHS) neAmerican Academy of Neurology (AAN) yakagadzira mirayiridzo yemishonga inorayira kuti kudzivirirwa kwepisodic migraine - migraines iyo isingazovipo mazuva 15 pamwedzi. Kunyange zvakadaro, mazhinji emishonga iyi inoshandiswa sekudzivirira kune avo vanotambura nekusingaperi migraines.
Zviratidzo zvekuchengetedza migraine mishonga.
- Antihypertensives (ropa rinoderedzera vashumiri)
- Antidepressants
- Anticonvulsants
- Petasites (Butterbur)
Dambudziko Ropa Ropa Kurapa Mishonga Inodzivirira Migraines
Mhando dzakawanda dzemishonga inoshandiswa kudzivirira migraine kurwisa. Ropa kudzvinyirira kudzvinyirira , kunyanya beta-blockers, zvinowanzoshandiswa.
IAHS / AAN yakagadzirisa kuti metoprolol, propranolol, uye timolol ndeyezinga A madhiragi. Izvi zvinoreva kuti vanoonekwa se "kubudirira" kwekudzivirira migraine, asi atenolol iri chirongwa B kana "zvichida kubudirira."
Beta-blockers inofanira kushandiswa nekuchenjerera kune avo vane chirwere cheshuga uye chirwere cheshuga uye zvinopesana neavo vane chirwere chema bradycardia (chirwere chepfungwa chepasi). Dzimwe mimwe migumisiro ye beta blockers dzinosanganisira mafungiro akaoma, kuneta, uye erectile kudzvinyirira.
Imwe ropa inodzvinyirira mishonga yakadai se verapamil, calcium-channel blocker , dzimwe nguva inoshandiswa kudzivirira migraines, kunyange zvazvo uchapupu hwezvesayenzi shure kwahwo husina kusimba sehwe beta-blockers. IAHS / AAN 2012 mirayiridzo inoratidzira verapamil se "U" mishonga, zvinoreva kuti "haana kukwana dhesi yekutsigira kana kuramba kushandiswa kwemigraine prophylaxis." Anhypertensives lisinopril uye candesartan (inozivikanwa seACE inhibitors) dzakarongerwa sezviyero zveC C AHS / AAN, iyo inoreva kuti "inogona kushanda" kubva pane imwe yedzidzo.
Anodzvinyirira Kuvhara Episodic Migraines
Zvinodzvinyirira , kunyanya amitriptyline uye venlafaxine, dzinofungidzirwa kuti Nhamba B zvinodhaka ("zvichida zvinobudirira") zvekudzivirira migraine. Venlafaxine (Effexor) ndiyo sarotonin-norepinephrine reuptake inhibitor.
Amitriptyline (Elavil) ndiyo yakanyanya kufanana ne-tricyclic inodzvinyirira iyo inobata nekuvhara reuptake yevanokonzerana neurotransmitter vaviri muuropi, serotonin uye norepinephrine. Icho chirwere chekuita sedate uye inowanzoitwa panhovo.
Amitriptyline inobvisawo acetylcholine receptors uye histamine receptors muuropi, zvichiita kuti zvigone kuitika kune anticholinergic migumisiro yakaita semuromo wakaoma, kuvimbiswa, nekuchengetwa kwemakuta. Izvo zvinogona kuita kuti uwedzere kuwedzera uye kuvhiringidzika. Pakupedzisira, amitriptyline inogona kuva nemigumisiro yakakomba yakadai sekuita kwepfungwa dzisina kunaka, saka inofanira kudziviswa kune avo vane chirwere chepfungwa pasi.
Anticonvulsants Kuti Vadzivirire Migoines Episodic
Maererano neanticonvulsants , American Academy of Neurology yakagumisa kuti zvinonzi valproate, divalproex sodium, uye sodium valproate, pamwe ne topiramate (topamax) inoshanda (Nhamba A madhiragi) mukudzivirira migraines. Zvimwe zvikamu zve topiramate zvinosanganisira
- kuonda
- kuneta
- chizoro
- paresthesias
- kusanganisa kusagadzikana
- tora kuchinja.
Zvimwe zvinokonzerwa nemishonga inonzi valproate inosanganisira: kuwedzera kuwandisa, kusuruvara, kudengenyeka, nekushaiwa bvudzi.
Butterbur uye Mamwe Mishonga Kudzivirira Episodic Migraine
Petasites (butterbur) imwe imwe Nhanho A mishonga inobudirira yekudzivirira migraine. Uyu ndiwo mishonga yemishonga kana imwe nzira inotorwa kaviri zuva rimwe nerimwe. Nyaya huru yechirwere ndeyoro GI inogumburwa, kunyanya kubhurwa.
Zvimwe zvezinga B zvinodhaka kana zvinodhaka izvo "zvichida zvinobudirira" zvekudzivirira migraine, sezvakataurwa neAmerican Headache Society uye American Academy of Neurology inosanganisira:
- Alternative Therapies : feverfew, magnesium, uye riboflavin
- Zvimwe NSAIDs (ibuprofen, naproxen)
- Zvimwe triptans (naratriptan, zolmitriptan): Ndapota ona , izvi zvinoratidzwa nokuda kwekuenda kumwedzi .
The Bottom Line
Mishonga inodzivirira dzimwe nguva inoratidzwa kuti kuderedze nhamba, kuoma, nguva, nekuremara kunobatanidza migraines. Maererano nenyanzvi, vamwe beta-blockers (metoprolol, timolol, propanolol), anticonvulsants (valproate products, topiramate), uye mishonga inowedzera butterbur yakagadzwa seNhamba A kana "inobudirira" semishonga inodzivirira ye episodic migraines.
Kana iwe ukaona kuti migraine yako inopesana nehupenyu hwako hwezuva nezuva kana hutano hwehupenyu, taura nachiremba wako pamusoro pezvinobvira zvinobatsira uye njodzi dzekutanga migraine mishonga yekudzivisa - zvingave chimwe chinhu chaunoda kwenguva pfupi kusvikira iwe unogona kuziva kuti migraine yako inotanga kana tsvaga nzira yakasiyana yekuita nayo.
Sources:
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Lipton RB, Göbel H, Einhäupl KM, Wilks K, Mauskop A. Petasites hybridus root (butterbur) inobatsira kurapwa kwemigraine. Neurology . 2004 Dec 28; 63 (12): 2240-4.
Loder E, Burch R, Rizzoli P. The 2012 AHS / AAN mirayiridzo yekudzivirira episodic migraine: chidimbu uye kuenzanisa nemamwe maitiro ekupedzisira ekurapa maitiro. Headache . 2012; 52: 930-45 .
Podrid P. Mazamu makuru emitambo ye beta blockers.In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
Silberstein SD, Holland S, Freitag F, et al. Evidence-based based guideline update: pharmacologic kurapa episodic migraine kudzivirira kune vanhu vakuru: mushumo weChristian Standards of Neurology uye American Headache Society. Neurology 2012; 78: 1337.
ZVINOKUDZIDZA: Mashoko ari panzvimbo ino ndeongangwa dzekudzidzisa chete. Icho hachifaniri kushandiswa sechinzvimbo chekuchengetedza iwe pachako nechiremba ane chiremba. Ndapota ona chiremba wako kuti aongororwe uye kurapwa chero kupi zvako pamusoro pezviratidzo kana chirwere chechiremba .