robsanchez
Forum Junior
Topics: 13
Posts: 50
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Pte, 25 year-old, on treatment(prophylactic and acute) for Migraine, comes to your office for annual examination, she has been complaining for slight chest pain.In the physical examination you find weak and delayed arterial pulses, and a diamond shaped systolic murmur grade 1,( whit no other findings) Which of the following drugs that she take can be the cause of this:
a) propanolol
b) sumatriptan
c) Ibuprofen
d) Methysergide
e) acetaminophen
How do you avoid this?
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| dxtxpx
Forum Guru
Topics: 259
Posts: 1,233
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methysergide, dont give it for more than 2-4 wks
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| asmi
Forum Hero
Topics: 1043
Posts: 4,609
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methysergide...
nitroprusside
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| robsanchez
Forum Junior
Topics: 13
Posts: 50
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yes the drug is Methysergide and the form to avoid this effect is is dont give it for long time, Dxtxpx says no more than 2 -4 wks, I don't know but I find in "Harrison" no more than 8 Months.
About Nitropusside I think that you can't decrease the PVR in a pte whit aortic stenosis because they have tissue hypoperfusion?
just tell me if I am wrong.....
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| asmi
Forum Hero
Topics: 1043
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yes u both r correct.. but i read in lippincott about ergotamines..it says its vasoconstrictor effect can be counteracted by nitroprusside.
Methysergide (Sansert), antiserotonin medication leading to vasoconstriction. Dose is 2-6 mg , Complications of long term use include pleuropulmonary fibrosis, retroperitoneal fibrosis, edema, valvular fibrosis. Most complications can be avoided if methysergide therapy is interrupted for 2 weeks after constant use for 3 months
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| robsanchez
Forum Junior
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Posts: 50
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thanks for the information 
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| asmi
Forum Hero
Topics: 1043
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it seems they don't use it in US. Instead they prefer ergotamine tartarate + caffeine ,for severe migraine .Although mainly NSAID'S are preferred for acute attack ( for the first time).
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