Loading...
Publication
Profilaxia medicamentosa da enxaqueca : estado da arte
Authors
Advisor(s)
Abstract(s)
A enxaqueca é uma doença neurológica crónica, bastante prevalente a nível mundial, que afeta todas as faixas etárias. Pode ser classificada, de acordo com a frequência com que se apresenta, em enxaqueca episódica ou enxaqueca crónica. O seu sintoma mais comum é a cefaleia, mas surge geralmente acompanhada de outros sintomas, inerentes à sua fisiopatologia.
Os critérios de diagnóstico preconizados na 3ª edição da Classificação Internacional de Cefaleias permitem ainda distinguir diversos subtipos da enxaqueca. O diagnóstico tem também como base a história clínica do doente, sendo as doenças do foro psiquiátrico e as doenças cardiovasculares as comorbilidades mais associadas à enxaqueca.
Apesar de não ter cura, a enxaqueca pode ser controlada com a ajuda de terapêutica profilática ou terapêutica aguda. O objetivo desta monografia passa por apresentar as várias opções medicamentosas utilizadas na profilaxia da enxaqueca.
O tratamento profilático da enxaqueca pretende reduzir a frequência das crises e pode ser farmacológico ou não farmacológico. A nível farmacológico destacam-se: fármacos β-bloqueadores; fármacos bloqueadores dos canais de cálcio; fármacos antidepressivos; fármacos antiepiléticos/anticonvulsivantes; toxina botulínica tipo A; anticorpos monoclonais anti-CGRP/anti-recetor de CGRP, sendo estes últimos a única classe desenvolvida especificamente para atuar na prevenção da enxaqueca. A terapêutica não farmacológica deve passar por modificações do estilo de vida e intervenções alternativas, ideais para doentes que apresentem contraindicações a alguns medicamentos.
A enxaqueca pode impactar negativamente a vida do doente em vários níveis, não só ao nível dos sintomas debilitantes que apresenta, mas também pelas consequências a nível da vida pessoal, social e profissional. O farmacêutico pode desempenhar aqui um importante papel, fornecendo o aconselhamento, acompanhamento e educação do doente, vitais para assegurar a adesão ao tratamento.
Migraine is a chronic neurological disease prevalent worldwide that affects all age groups. It can be categorized according to its frequency into episodic and chronic migraines. The most common symptom is headache, but it is usually accompanied by other symptoms that are inherent to its pathophysiology. The diagnostic criteria recommended in the 3rd edition of the International Classification of Headache Disorders also make it possible to distinguish between the various migraine subtypes. The diagnosis is also based on the patient's clinical history, with psychiatric disorders and cardiovascular diseases being the most associated comorbidities. Although migraine cannot be cured, it can be controlled using prophylactic or acute therapy. The aim of this monograph was to present various drug options for migraine prophylaxis. Prophylactic treatment for migraine aims to reduce the frequency of attacks and can be pharmacological or non-pharmacological. Pharmacological treatments include β-blockers, calcium channel blockers, antidepressants, antiepileptic/anticonvulsant drugs, botulinum toxin type A, and anti-CGRP/anti-CGRP receptor monoclonal antibodies, with the latter being the only class developed specifically to prevent migraine. Non-pharmacological therapy should include lifestyle changes and alternative interventions, ideal for patients who have contraindications to certain medications. Migraine can have a negative impact on a patient's life on several levels, not only in terms of the debilitating symptoms it causes but also the consequences for personal, social, and professional life. Pharmacists can play an important role in providing counseling, monitoring, and patient education that are vital for ensuring adherence to treatment.
Migraine is a chronic neurological disease prevalent worldwide that affects all age groups. It can be categorized according to its frequency into episodic and chronic migraines. The most common symptom is headache, but it is usually accompanied by other symptoms that are inherent to its pathophysiology. The diagnostic criteria recommended in the 3rd edition of the International Classification of Headache Disorders also make it possible to distinguish between the various migraine subtypes. The diagnosis is also based on the patient's clinical history, with psychiatric disorders and cardiovascular diseases being the most associated comorbidities. Although migraine cannot be cured, it can be controlled using prophylactic or acute therapy. The aim of this monograph was to present various drug options for migraine prophylaxis. Prophylactic treatment for migraine aims to reduce the frequency of attacks and can be pharmacological or non-pharmacological. Pharmacological treatments include β-blockers, calcium channel blockers, antidepressants, antiepileptic/anticonvulsant drugs, botulinum toxin type A, and anti-CGRP/anti-CGRP receptor monoclonal antibodies, with the latter being the only class developed specifically to prevent migraine. Non-pharmacological therapy should include lifestyle changes and alternative interventions, ideal for patients who have contraindications to certain medications. Migraine can have a negative impact on a patient's life on several levels, not only in terms of the debilitating symptoms it causes but also the consequences for personal, social, and professional life. Pharmacists can play an important role in providing counseling, monitoring, and patient education that are vital for ensuring adherence to treatment.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Enxaqueca Profilaxia Terapêutica Fármacos