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Verapamil is a class-IV antiarrhythmic and more effective than digoxin in controlling ventricular rate. [19] Verapamil is not listed as a first line antihypertensive agent by the guidelines provided by JAMA in JNC-8. [20] However, it may be used to treat hypertension if patient has co-morbid atrial fibrillation or other types of arrhythmia. [17 ...
The drugs are started at a low dose, which is gradually increased until therapeutic effects develop, the ceiling dose for the chosen drug is reached, or side effects become intolerable. Preventive migraine medications are considered effective if they reduce the frequency or severity of the migraine attacks by at least 50%. [11]
Rescue treatment involves acute symptomatic control with medication. [4] Recommendations for rescue therapy of migraine include: (1) migraine-specific agents such as triptans, CGRP antagonists, or ditans for patients with severe headaches or for headaches that respond poorly to analgesics, (2) non-oral (typically nasal or injection) route of administration for patients with vomiting, (3) avoid ...
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Improvement can be seen in an average of 1.7 weeks for episodic cluster headache and 5 weeks for chronic cluster headache when using a dosage of ranged between 160 and 720 mg (mean 240 mg/day). [50] Preventive therapy with verapamil is believed to work because it has an effect on the circadian rhythm and on CGRPs.
Opioids are not recommended for treatment of acute migraines due to their significant side effect profile, including twice the risk of medication overuse headache when compared to NSAIDS, acetaminophen or triptans. [3] In addition, their strength of efficacy has showed to be low or insufficient for pain relief of migraines. [3]