RESUMO
The case reported here concerns a 40-year-old woman who has suffered from severe migraine without aura since she was 23. The patient has been taking 1-3 suppositories of Virdex (2 mg of ergotamine tartrate, 250 mg of aminophenazone, caffeine) every day for the past three years. In addition to headache, the onset of short, sporadic cramps in the limbs together with paresthesia, hyposthenia, hypothermia and skin pallor with a slight increase in diastolic pressure, made hospital treatment necessary. Instrumental investigation through a stress test on a moving carpet, doppler, echo-doppler and digitalized angiography of the arterial vessels of the lower limbs shows the presence of bilateral impairment attributable to the chronic intake of ergotamine.
Assuntos
Doenças Cardiovasculares/induzido quimicamente , Ergotamina/efeitos adversos , Transtornos de Enxaqueca/tratamento farmacológico , Adulto , Pressão Sanguínea/efeitos dos fármacos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Ecocardiografia Doppler , Ergotamina/uso terapêutico , Extremidades/fisiopatologia , Feminino , Artéria Femoral/efeitos dos fármacos , Artéria Femoral/fisiopatologia , Humanos , Artéria Ilíaca/efeitos dos fármacos , Artéria Ilíaca/fisiopatologia , Artéria Poplítea/efeitos dos fármacos , Artéria Poplítea/fisiopatologiaRESUMO
Raynaud's phenomenon (Raynaud's disease), an accessual vascular acrosyndrome characterised by an important constriction of distal arterioles, has still no specific pharmacological therapy. In the last years, the use of calcium-entry-blockers (nifedipine, diltiazem, verapamil, nicardipine), drugs able to control the contractility of the vessels, showed some positive results. Considering this data, we appraised the efficacy of flunarizine, another calcium-entry-blocker, in a preliminary study of 28 patients (23 females, 5 males, aged between 15 and 48 years) suffering from Raynaud's disease. Apart from a statistically insignificant improvement of subjective symptoms (i.e. acroparesthesias, cold extremities) flunarizine (10 mg/day for 1 month) did not have positive results. Finally, this drug caused some side-effects: drowsiness, increase of weight and appetite, but without a real necessity for withdrawal of therapy.
Assuntos
Flunarizina/uso terapêutico , Doença de Raynaud/tratamento farmacológico , Adolescente , Adulto , Feminino , Flunarizina/administração & dosagem , Flunarizina/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
The use of flunarizine, a drug which has proven its efficacy in migraine, is often associated with important side effects. The aim of this paper has been to check their incidence at different dose levels (5 mg vs 10 mg). Our data confirm the occurrence of important side effects (in particular weight gain); on the other hand, they emphasize the dose-dependency of the side effects.
