Ketorolac versus meperidine-plus-promethazine treatment of migraine headache: Evaluations by patients

Davis, Charles P.; Torre, Paul R; Williams, Charles H.; Gray, Colin; Barrett, Kevin; Krucke, Gus W.; Peake, Dwight; Bass, Bill

doi:10.1016/0735-6757(95)90081-0

Cited by 44 publications

(40 citation statements)

References 10 publications

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“…Intramuscular ketorolac 30 mg had less efficacy than 75 mg meperidine [114], but a dose of 60 mg was as effective as 75 mg meperidine (plus 25 mg promethazine) [115] or 100 mg meperidine (plus 50 mg hydroxyzine) or 25 mg chlorpromazine iv [116] in rather small randomized trials performed in emergency departments (n = 30 to 47 patients included). Ketorolac 30 mg iv (n = 64) was inferior to 10 mg iv prochlorperazine [117], but more effective than 20 mg nasal sumatriptan (n = 29) [118].…”

Section: Results Of Randomized Controlled Trialsmentioning

confidence: 99%

NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data

Párdutz

Schoenen

2010

Pharmaceuticals

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Migraine is a common disabling neurological disorder with a serious socio-economical burden. By blocking cyclooxygenase nonsteroidal anti-inflammatory drugs (NSAIDs) decrease the synthesis of prostaglandins, which are involved in the pathophysiology of migraine headaches. Despite the introduction more than a decade ago of a new class of migraine-specific drugs with superior efficacy, the triptans, NSAIDs remain the most commonly used therapies for the migraine attack. This is in part due to their wide availability as over-the-counter drugs and their pharmaco-economic advantages, but also to a favorable efficacy/side effect profile at least in attacks of mild and moderate intensity. We summarize here both the experimental data showing that NSAIDs are able to influence several pathophysiological facets of the migraine headache and the clinical studies providing evidence for the therapeutic efficacy of various subclasses of NSAIDs in migraine therapy. Taken together these data indicate that there are several targets for NSAIDs in migraine pathophysiology and that on the spectrum of clinical potency acetaminophen is at the lower end while ibuprofen is among the most effective drugs. Acetaminophen and aspirin excluded, comparative trials between the other NSAIDs are missing. Since evidence-based criteria are scarce, the selection of an NSAID should take into account proof and degree of efficacy, rapid GI absorption, gastric ulcer risk and previous experience of each individual patient. If selected and prescribed wisely, NSAIDs are precious, safe and cost-efficient drugs for the treatment of migraine attacks.

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Section: Results Of Randomized Controlled Trialsmentioning

confidence: 99%

NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data

Párdutz

Schoenen

2010

Pharmaceuticals

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“…In EDs, the most effective medications have been shown to be the ergot derivatives, the triptans, and the phenothiazines (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Lacking the vasoconstrictive properties of ergots and triptans, phenothiazines have recently received more attention.…”

Section: Importancementioning

confidence: 99%

Prochlorperazine vs. Promethazine for Headache Treatment in the Emergency Department: A Randomized Controlled Trial

Callan

Kostic

Bachrach

et al. 2008

The Journal of Emergency Medicine

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“…No controlled trial has shown any NSAID to be superior to another in migraine [41,Class IIIc]. Intramuscular ketorolac, 60 mg, has been found effective in emergency room settings for the acute treatment migraine-type headaches [42,Class IIIa]. Whether any of these agents are useful in the treatment of acute post-traumatic headache or acute migraine-like episodes of post-traumatic headaches is uncertain.…”

Section: Abortive Medications-nonsteroidal Anti-inflammatory Agentsmentioning

confidence: 98%

Post-traumatic headache

Lane¹,

Arciniegas²

2002

Curr Treat Options Neurol

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Headache is the most common symptom after closed head injury, persisting for more than 2 months in 60% of patients. Rarely does headache occur in isolation. Cervical pain is a frequent accompaniment. Post-traumatic headache is often one of several symptoms of the postconcussive syndrome, and therefore may be accompanied by additional cognitive, behavioral, and somatic problems. Acute post-traumatic headaches may begin at the time of injury and continue for up to 2 months post-injury. Although onset proximate to the time of injury is most common, any new headache type occurring within this period of time is referred to as an acute post-traumatic headache. If such headaches persist beyond the first two months post-injury, they are subsequently referred to as chronic post-traumatic headaches. Over time, post-traumatic headaches may take on a pattern of daily occurrence. If aggressive treatment is initiated early, posttraumatic headache is less likely to become a permanent problem. Once "windup" of post-traumatic headaches occurs, the cycle of ongoing headaches is more difficult to interrupt. The mechanism of post-traumatic headache is poorly understood. Trauma-induced headaches are usually heterogeneous in nature, often including both tension-type pain and intermittent migraine-like attacks. Rebound-headaches may develop from overuse of analgesic medications, and the occurrence of such may complicate significantly the diagnosis of post-traumatic headache. Adequate treatment typically requires both "peripheral" and "central" measures. Understanding the general principles of treatment, especially appropriate use of preventive and abortive medications, will most usefully guide treatment. There is scant literature with which to direct treatment selection for post-traumatic headache. Consequently, treatments for post-traumatic headache are based on those prescribed for phenomenologically similar but etiologically distinct headache disorders. Delayed recovery from post-traumatic headache may be a result of inadequately aggressive or ineffective treatment, overuse of analgesic medications resulting in analgesia rebound phenomena, or comorbid psychiatric disorders (eg, post-traumatic stress disorder, insomnia, substance abuse, depression, or anxiety).

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Ketorolac versus meperidine-plus-promethazine treatment of migraine headache: Evaluations by patients

Cited by 44 publications

References 10 publications

NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data

NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data

Prochlorperazine vs. Promethazine for Headache Treatment in the Emergency Department: A Randomized Controlled Trial

Post-traumatic headache

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