Use of ergotamine: Do physicians in Colombia know how to prescribe it?

Machado‐Alba, Jorge Enrique; Morales-Plaza, Cristhian David

doi:10.1016/j.nrleng.2013.06.003

Cited by 4 publications

(5 citation statements)

References 32 publications

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“…Finally, it was identified that almost all of the prescriptions were made by general practitioners, which provides an opportunity to implement continuing education and therapeutic update strategies for this group of professionals, in an effort to reduce potentially inappropriate opioid prescriptions. The findings in differences between regions have been previously described in pharmacoepidemiological studies, opening opportunities for the implementation of clinical practice guidelines and updates for physicians, especially those in regions with greater formulations [ 4 , 16 , 21 ].…”

Section: Discussionmentioning

confidence: 72%

“…This is mainly due to safety problems derived from its low selectivity for the serotonin receptor, which increases the probability of adverse cardiovascular and neurological reactions [ 14 , 15 ]. In Colombia, the greater use of ergotamine was also associated with a poor recommendation for dosage and interval in almost all patients to whom it was prescribed [ 16 ]. This increases the probability of adverse reactions; added to the inappropriate use of opioids, this can be associated with the chronification of migraine [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Potentially Inappropriate Use of Opioids in the Management of Migraine in Colombia

Machado-Duque,

Echeverry-Gutiérrez,

Gaviria-Mendoza

et al. 2023

Biomedicines

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Research objective: To identify the frequency of opioid use in a group of patients diagnosed with migraine in Colombia. Methods: Study of a retrospective cohort of patients with a diagnosis of migraine and a first prescription of antimigraine drugs from emergency services and a priority outpatient clinic. Sociodemographic, clinical, and pharmacological variables were identified; a 12-month follow-up was carried out to identify the use of a new opioid. Results: A total of 6309 patients with a diagnosis of migraine were identified, with a mean age of 35.5 ± 12.3 years, of which 81.3% were women. Nonsteroidal anti-inflammatory drugs (51.1%) were the most frequently prescribed medications, followed by ergotamine + caffeine (31.3%), acetaminophen (15.05%), and acetaminophen + codeine (14.4%). At the time of the index, 1300 (20.6%) patients received some opioid. During the follow-up, a total of 1437 (22.8%) patients received a new opioid, of which 31.8% belonged to the group that received an initial opioid and 20.4% to the group that did not receive one, which was statistically significant (OR:1.81; 95%CI:1.58–2.07; p < 0.001). Conclusions: The frequent use of opioids in the management of migraines is potentially inappropriate and can lead to problems of tolerance, abuse and dependence. This combined with the low prescription of triptans, offers an opportunity for improvements in medical practice.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Potentially Inappropriate Use of Opioids in the Management of Migraine in Colombia

Machado-Duque,

Echeverry-Gutiérrez,

Gaviria-Mendoza

et al. 2023

Biomedicines

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“…Ergotamine is a famous pharmacological remedy applied in obstetrics and neurology. Migraineurs improperly taking ergotamine may increase the risk of coronary events, ergotism, and other health problems due to the potential interactions 80. The long-term use of ergotamine for the treatment of migraine is associated with cardiac fibrotic and pleuropulmonary reactions.…”

Section: Resultsmentioning

confidence: 99%

“…Migraineurs improperly taking ergotamine may increase the risk of coronary events, ergotism, and other health problems due to the potential interactions. 80 The long-term use of ergotamine for the treatment of migraine is associated with cardiac fibrotic and pleuropulmonary reactions. It causes blood vessel constriction through blockage of the alpha-receptors and stimulation of the serotonin-receptors on blood vessel walls in the peripheral circulation and CNS.…”

Section: Resultsmentioning

confidence: 99%

Pharmacoinformatics elucidation of potential drug targets against migraine to target ion channel protein KCNK18

Sehgal¹,

Hassan²,

Rashid³

2014

DDDT

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Migraine, a complex debilitating neurological disorder is strongly associated with potassium channel subfamily K member 18 (KCNK18). Research has emphasized that high levels of KCNK18 may be responsible for improper functioning of neurotransmitters, resulting in neurological disorders like migraine. In the present study, a hybrid approach of molecular docking and virtual screening were followed by pharmacophore identification and structure modeling. Screening was performed using a two-dimensional similarity search against recommended migraine drugs, keeping in view the physicochemical properties of drugs. LigandScout tool was used for exploring pharmacophore properties and designing novel molecules. Here, we report the screening of four novel compounds that have showed maximum binding affinity against KCNK18, obtained through the ZINC database, and Drug and Drug-Like libraries. Docking studies revealed that Asp-46, Ile-324, Ile-44, Gly-118, Leu-338, Val-113, and Phe-41 are critical residues for receptor–ligand interaction. A virtual screening approach coupled with docking energies and druglikeness rules illustrated that ergotamine and PB-414901692 are potential inhibitor compounds for targeting KCNK18. We propose that selected compounds may be more potent than the previously listed drug analogs based on the binding energy values. Further analysis of these inhibitors through site-directed mutagenesis could be helpful for exploring the details of ligand-binding pockets. Overall, the findings of this study may be helpful for designing novel therapeutic targets to cure migraine.

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“…En Colombia, Machado-Alba et al 8 , sostienen que la ergotamina es un medicamento que se formula de forma incorrecta y que, de 801 pacientes a los cuales se les prescribió ergotamina en 27 ciudades de Colombia, 797 fueron prescritos de forma inadecuada. La mayoría de las formulaciones fueron por medicina general (96.5%).…”

Section: Discussionunclassified

Ergotamina y terapia antiretroviral: una combinación peligrosa. Reporte de caso

Hernandez-Torres

Rivera-Tenorio

Moreno-Ortega

et al. 2022

Infect

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El ergotismo es una condición clínica rara caracterizada por vasoconstricción generalizada producida por la administración de medicamentos derivados del Ergot. Principalmente mediado por la interacción entre medicamentos, entre ellos figuran los antibióticos, anticonceptivos orales y antivirales. Se presenta el caso de un paciente de 28 años, con infección por virus de la inmunodeficiencia humana en manejo antirretroviral con inhibidores de la proteasa que consumió concomitantemente ergotamina con lo cual desarrollo dolor intenso, frialdad, parestesias y cianosis de los miembros inferiores asociado a una lesión ulcerada en el dorso del pie derecho, se consideró episodio de vasoespasmo secundario a ergotismo, dentro del diferencial toman relevancia las vasculitis. Presentó mejoría tras la suspensión de los medicamentos que estaban relacionados y el uso de vasodilatador. El propósito del caso es hacer énfasis en una interacción medicamentosa grave como lo es la de la ergotamina más inhibidores de la proteasa.

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Use of ergotamine: Do physicians in Colombia know how to prescribe it?

Cited by 4 publications

References 32 publications

Potentially Inappropriate Use of Opioids in the Management of Migraine in Colombia

Potentially Inappropriate Use of Opioids in the Management of Migraine in Colombia

Pharmacoinformatics elucidation of potential drug targets against migraine to target ion channel protein KCNK18

Ergotamina y terapia antiretroviral: una combinación peligrosa. Reporte de caso

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