Journal of pain and symptom management
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J Pain Symptom Manage · Feb 1993
Treatment considerations in headache and associated medical disorders.
As more headache sufferers seek medical care for their headaches, it is incumbent on physicians to consider all of a patient's medical illnesses in choosing therapy. The availability of new medications for headache will facilitate the tailoring of treatment to specific patient needs. The physician who treats patients with headache and concomitant medical problems must be knowledgeable about the pharmacology and adverse effects of these agents. This will permit the practitioner to use specific therapy, limit the number of medications prescribed, and prevent an exacerbation of either the medical condition or the headaches.
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A variety of evidence suggests a link between migraine and the female sex hormones. Women with migraine outnumber men by at least a 2:1 ratio and definite patterns of development and attacks are noted at menarche and throughout the period of menses, related to trimester of pregnancy, and again at menopause, although it may also regress. Hormonal replacement with estrogen can exacerbate migraine; oral contraceptives can change the character and frequency of migraine headache. This article will cover approaches to the therapy of hormone-related headaches associated with the menstrual cycle, menopause, and oral contraceptives.
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Deciding whether a child's headache is functional or organic is difficult for even the experienced physician. This review examines the diagnosis and management of headache syndromes in children and adolescents. A systematic history and examination together with selected laboratory data will enable the practitioner to establish the correct diagnosis.
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J Pain Symptom Manage · Feb 1993
ReviewA review of oxycodone's clinical pharmacokinetics and pharmacodynamics.
Oxycodone (14-hydroxy-7,8-dihydrocodeinone) is a strong opioid agonist that is available alone or in combination with mild analgesics. It is suitable for oral administration due to high bioavailability (60%), and may also be given intramuscularly, intravenously, subcutaneously, and rectally; it is not recommended for spinal administration. In analgesic potency, oxycodone is comparable to morphine. ⋯ The abuse potential of oxycodone is equivalent to that of morphine. The usual indications for oxycodone are severe acute postoperative or posttraumatic pain and cancer pain. When oxycodone is administered, the same precautions should be taken as with morphine or other agonist opioids.