34.有關預防偏頭痛藥品之說明，下列何者錯誤？
(A)Propranolol為第一線用藥，atenolol也有效
(B)Verapamil在用藥後約三天時可達最佳效果
(C)Naproxen對女性經期相關的偏頭痛有效
(D)Methysergide因副作用大，列為後線藥品

答案：登入後查看
統計： A(823), B(1938), C(243), D(142), E(0) #537505

詳解 (共 10 筆)

#879428
B.Verapamil能有效預防偏頭痛在用藥後約一個星期時可達最佳效果，常用的計量360-720mg/day。
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#2348859

Methysergide最後線使用 會造成纖維化 每六個月實行藥物假期

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#879468

Propranolol（Inderal）很安全、有效又有大量的研究支持它的藥效，使Propanolol成為預防偏頭痛療程中的第一線用藥。而當病人對Propranolol的CNS副作用無法忍受時，Atenolol是適當的替代藥物。

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#2771026

轉貼

急性用藥

預防用藥

triptan

sumatriptan

- -  

ergot類

dihydroergotamine , ergotamnine

- -  

鴉片類

morphine, butorphanol

- -  


- -

propanolol


- -

verapamil

NSAID

ibuprofen, naproxen

naproxen, ibuprofen


- -

VPA


- -

TCA, Methysergide

止吐劑

metoclopromide

- -

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0
#2331384
Verapamil用在預防偏頭痛，為二線...
(共 45 字，隱藏中）
前往觀看
37
1
#879465

Propranolol抗偏頭痛的作用機轉目前還是未知的。因此醫學上建立了一個假說來解釋它的作用機轉，就是雖然這個β-bloker藥物對大腦的血流沒有明顯的影響，但是可以防止偏頭痛所引起的血管擴張，而這個作用機轉又和serotonergic system有關。Propranolol對Serotonin的受器有很高的親和力且可以抑制體內或是體外（in vivo/in vitro）血小板的攝取。

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#2350129

verapamil 1-2months 見效

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#3478254
比較52.52 下列何者可預防肝硬化病人...
(共 492 字，隱藏中）
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#4795699
Applied P.1351Verapa...
(共 463 字，隱藏中）
前往觀看
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#6270873
Uptodate 2024
叢發型Cluster headache, prevention (off-label use):
Note: May be used as monotherapy or in combination with other preventive and/or bridging agents (eg, glucocorticoids (Ref)). Example regimens are presented below. Obtain an ECG prior to treatment and after each titration when dose is >480 mg/day (Ref).
Oral:
Immediate release: Initial: 40 to 80 mg 3 times daily; increase dose every 1 to 2 weeks until headaches subside or adverse reactions develop; usual effective dose: 240 to 480 mg/day in 3 to 4 divided doses (Ref).
Extended release: Initial: 240 mg in 2 divided doses; increase dose every 1 to 2 weeks until headaches subside or adverse reactions develop; usual effective dose: 240 to 480 mg/day in 2 divided doses (Ref).
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偏頭痛Migraine, prevention (off-label use):
Note: Tolerance may develop; consider increasing dose or switching to another calcium channel blocker if tolerance occurs (Ref). An adequate trial for assessment of effect is considered to be at least 2 to 3 months at a therapeutic dose (Ref).
Oral:
Immediate release: Initial: 40 mg 3 times daily; titrate every 1 to 2 weeks based on patient response and tolerability up to 480 mg/day in 3 to 4 divided doses (Ref).
Extended release: Initial: 120 mg once daily; titrate every 1 to 2 weeks based on patient response and tolerability up to 480 mg/day in 2 to 3 divided doses (Ref).
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