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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Pharmacological Acute Migraine Treatment Strategies: Choosing the Right Drug for a Specific Patient
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Pharmacological Acute Migraine Treatment Strategies: Choosing the Right Drug for a Specific Patient

机译：急性偏头痛药理学治疗策略：为特定患者选择正确的药物

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Background: In our targeted review (Section 2), 12 acute medications received a strong recommendation for use in acute migraine therapy while four received a weak recommendation for use. Strong recommendations were made to avoid use of two other medications, except for exceptional circumstances. Two anti-emetics received strong recommendations for use as needed. Objective: To organize the available acute migraine medications into acute migraine treatment strategies in order to assist the practitioner in choosing a specific medication(s) for an individual patient. Methods: Acute migraine treatment strategies were developed based on the targeted literature review used for the development of this guideline (Section 2), and a general literature review. Expert consensus groups were used to refine and validate these strategies. Results: Based on evidence for drug efficacy, drug side effects, migraine severity, and coexistent medical disorders, our analysis resulted in the formulation of eight general acute migraine treatment strategies. These could be grouped into four categories: 1) two mild-moderate attack strategies, 2) two moderate-severe attack or NSAID failure strategies, 3) three refractory migraine strategies, and 4) a vasoconstrictor unresponsive-contraindicated strategy. In addition, strategies were developed for menstrual migraine, migraine during pregnancy, and migraine during lactation. The eight general treatment strategies were coordinated with a "combined acute medication approach" to therapy which used features of both the "stratified" and the "step care across attacks" approaches to acute migraine management. Conclusions: The available medications for acute migraine treatment can be organized into a series of strategies based on patient clinical features. These strategies may help practitioners make appropriate acute medication choices for patients with migraine.
机译：背景：在我们的针对性综述（第2节）中，有12种急性药物强烈推荐用于急性偏头痛治疗，而有4种药物弱推荐。强烈建议避免使用两种其他药物，除非特殊情况。两种止吐药均根据需要获得了强烈的使用建议。目的：将可用的急性偏头痛药物组织到急性偏头痛治疗策略中，以帮助从业者为个别患者选择特定的药物。方法：急性偏头痛治疗策略的制定是基于针对该指南制定的目标文献综述（第2节）和一般文献综述。专家共识小组用于完善和验证这些策略。结果：基于药物功效，药物副作用，偏头痛严重程度和共存的医学疾病的证据，我们的分析得出了八种通用的急性偏头痛治疗策略。这些可以分为四类：1）两种轻度-中度发作策略，2）两种中度-重度发作或NSAID失败策略，3）三种难治性偏头痛策略和4）血管收缩剂无反应性禁忌策略。此外，还制定了针对月经偏头痛，妊娠期偏头痛和哺乳期偏头痛的策略。八种一般治疗策略与“联合急性药物治疗方法”相结合，采用“分层”和“跨发作的分步护理”方法进行急性偏头痛治疗。结论：可以根据患者的临床特点将可用于急性偏头痛治疗的药物分为一系列策略。这些策略可以帮助从业者为偏头痛患者做出适当的急性药物选择。

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