Healthcare Traveler - October 2008 - (Page 44) Drug Update Pain Clinic T H E L AT E S T D E V E LO PM EN T S I N R E SE A RCH What’s New for Menstrual Migraine? Q A 42-year-old premenopausal woman reports severe migraine headaches and menstrual cramps preceding her menses by two to three days. She has taken a nonsteroidal antiinflammatory drug (NSAID), which helps her cramps but not the headaches. How can the headache be managed? A. One choice for migraine treatment is sumatriptan 85 mg and naproxen sodium 500 mg (Treximet). She should take one at onset of a migraine, and may repeat once within 24 hours. This combination is more effective than one or the other alone. Sumatriptan-naproxen was found well-tolerated in two large, randomized, double-blind studies. The combination may increase risk of cardiovascular events, MI, and stroke, which may rise with duration of use. NSAIDs increase risk of adverse GI, events including bleeding, ulceration, and stomach or intestinal perforations. MAO inhibitors cannot be taken with Treximet, nor should it be given to patients with allergic or asthmatic reactions to NSAIDs. Brandes, J. L., et al. (2007). “Sumatriptan-naproxen for acute treatment of migraine.” JAMA, 297(3), 1443. Hold lifted on drug to treat bowel dysfunction T MARY SCHOLZ, RN, BSN, MS, PhD, is a nurse clinician and behavior medicine specialist at Northwest Psychophysiology, an affiliate of the Northwest Neuroscience Institute in Seattle. he FDA has lifted its clinical hold on an investigational new drug application for alvimopan (Entereg), an opioid receptor antagonist meant to treat chronic opioid bowel dysfunction, such as constipation related to the use of opioid painkillers. The FDA approved the drug in May as a treatment for postoperative ileus, a bowel function disorder, in patients who had undergone bowel resection surgeries. In June 2007, the FDA placed a clinical hold on studies of alvimopan until the federal agency could complete its review of additional study data it had requested from the companies that developed the drug. That data included results from clinical studies in patients with cancer pain, from a trial testing the drug in combination with hydrocodone Circle Career Card No. 638 Circle Career Card No. 600 44 Healthcare Traveler October 2008 www.healthcaretraveler.com http://www.acrossamer.com http://www.travelphp.com http://www.healthcaretraveler.com
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