{"id":3553,"count":18,"description":"Migr\u00e9na postihuje p\u0159ibli\u017en\u011b 12 % dosp\u011bl\u00fdch celosv\u011btov\u011b<\/strong> \u2014 zhruba t\u0159i \u010dtvrtiny pacient\u016f jsou \u017eeny a vrchol v\u00fdskytu je ve v\u011bkov\u00e9 skupin\u011b 25-55 let. Na rozd\u00edl od tenzn\u00ed bolesti hlavy je migr\u00e9na v\u00fdrazn\u00e1 neurologick\u00e1 porucha<\/strong> vyvol\u00e1na aktivac\u00ed trojklann\u00e9ho nervu, uvoln\u011bn\u00edm peptidu souvisej\u00edc\u00edho s genem pro kalcitonin (CGRP) a kortik\u00e1ln\u00ed \u0161\u00ed\u0159\u00edc\u00ed se depres\u00ed. Typick\u00fd z\u00e1chvat trv\u00e1 4\u201372 hodin se st\u0159edn\u011b silnou a\u017e silnou pulzuj\u00edc\u00ed bolest\u00ed, \u010dasto jednostrannou, s nevolnost\u00ed, fotofobi\u00ed a fonofobi\u00ed; p\u0159ibli\u017en\u011b 30 % posti\u017een\u00fdch za\u017e\u00edv\u00e1 p\u0159edch\u00e1zej\u00edc\u00ed vizu\u00e1ln\u00ed, senzorickou nebo motorickou auru.\n\nL\u00e9\u010dba migr\u00e9ny na MedsBase se \u0159\u00edd\u00ed dvoukolejn\u00fdm p\u0159\u00edstupem doporu\u010den\u00fdm Americkou spole\u010dnost\u00ed pro bolesti hlavy, NICE a Evropskou federac\u00ed pro bolesti hlavy: akutn\u00ed (abortivn\u00ed) l\u00e9\u010dba<\/strong> u\u017e\u00edvan\u00e1 p\u0159i prvn\u00edch zn\u00e1mk\u00e1ch z\u00e1chvatu, plus preventivn\u00ed l\u00e9\u010dba<\/strong> u\u017e\u00edvan\u00e1 denn\u011b, pokud se z\u00e1chvaty vyskytuj\u00ed v\u00edce ne\u017e 4kr\u00e1t m\u011bs\u00ed\u010dn\u011b nebo jsou invalidizuj\u00edc\u00ed.\n\nAkutn\u00ed (abortivn\u00ed) l\u00e9\u010dba dostupn\u00e1 na MedsBase:<\/strong> Rizatriptan<\/strong> (Maxtan<\/a>, Rizatop<\/a>, Rizact<\/a>) \u2014 nejrychleji \u00fa\u010dinkuj\u00edc\u00ed peror\u00e1ln\u00ed triptan s nejvy\u0161\u0161\u00ed m\u00edrou \u00falevy od bolesti do 2 hodin. Sumatriptan<\/strong> (Sumitop<\/a>, Leemigran<\/a>) \u2014 p\u016fvodn\u00ed triptan a nejl\u00e9pe prozkouman\u00e1 mo\u017enost. Zolmitriptan<\/strong> (Zolitas ODS<\/a> \u2014 or\u00e1ln\u011b dispergovateln\u00fd, a Zolmist nosn\u00ed sprej<\/a> \u2014 nejrychlej\u0161\u00ed n\u00e1stup \u00fa\u010dinku za 10-15 minut). Fixn\u00ed kombinace Sumatriptanu a Naproxenu<\/strong> (Trinicalm Plus<\/a> \u2014 generikum Treximetu, \u00fa\u010dinn\u011bj\u0161\u00ed ne\u017e jednotliv\u00e9 slo\u017eky samostatn\u011b). Pro m\u00edrn\u00e9 a\u017e st\u0159edn\u011b z\u00e1va\u017en\u00e9 z\u00e1chvaty, Naprosyn (naproxen)<\/a> je NSAID volby.\n\nPreventivn\u00ed l\u00e9\u010dba skladem na MedsBase:<\/strong> Propranolol<\/strong> (Inderal<\/a> IR a Inderal LA<\/a>) \u2014 klasick\u00e1 prvn\u00ed linie prevence; bezpe\u010dn\u00e1 v t\u011bhotenstv\u00ed; 80-160 mg\/den. Topiramate<\/strong> (Topicon<\/a>) \u2014 schv\u00e1leno FDA k prevenci migr\u00e9ny; c\u00edlov\u00e1 d\u00e1vka 100 mg\/den; zp\u016fsobuje \u00fabytek hmotnosti; kontraindikov\u00e1no v t\u011bhotenstv\u00ed. Flunarizin<\/strong> (Sibelium<\/a>) \u2014 evropsk\u00fd l\u00e9k prvn\u00ed volby ze skupiny blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f; 10 mg na noc; zvl\u00e1\u0161t\u011b \u00fa\u010dinn\u00fd u d\u011btsk\u00e9 a vestibul\u00e1rn\u00ed migr\u00e9ny; maxim\u00e1ln\u00ed d\u00e9lka l\u00e9\u010dby 6 m\u011bs\u00edc\u016f. Valpro\u00e1t sodn\u00fd<\/strong> (Encorate<\/a> IR a Encorate Chrono<\/a> ER) \u2014 ur\u010deno pro pacienty, u kter\u00fdch selhala l\u00e9\u010dba prvn\u00ed volby; vysoce teratogenn\u00ed, proto se nepou\u017e\u00edv\u00e1 u \u017een v reproduk\u010dn\u00edm v\u011bku bez form\u00e1ln\u00ed antikoncepce.\n\nD\u016fle\u017eit\u00e9 bezpe\u010dnostn\u00ed upozorn\u011bn\u00ed \u2014 bolest hlavy z nadu\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f.<\/strong> U\u017e\u00edv\u00e1n\u00ed triptan\u016f, ergotamin\u016f nebo kombinovan\u00fdch analgetik v\u00edce ne\u017e 10 dn\u00ed v m\u011bs\u00edci<\/strong>, nebo jednoduch\u00fdch NSAID\/paracetamolu v\u00edce ne\u017e 15 dn\u00ed v m\u011bs\u00edci<\/strong>, zp\u016fsobuje paradoxn\u00ed rebound bolest hlavy zvanou bolest hlavy z nadu\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f (MOH)<\/em>. Pokud pot\u0159ebujete akutn\u00ed l\u00e9\u010dbu \u010dast\u011bji ne\u017e tyto limity, je nutn\u00e9 p\u0159idat preventivn\u00ed l\u00e9k, nikoli dal\u0161\u00ed akutn\u00ed medikaci. Vedejte si den\u00edk migr\u00e9ny se z\u00e1znamem dn\u016f s akutn\u00ed medikac\u00ed \u2014 pokud p\u0159ekro\u010d\u00edte hranici, za\u010dn\u011bte s preventivn\u00ed l\u00e9\u010dbou.\n\nMigr\u00e9na je chronick\u00e9 onemocn\u011bn\u00ed \u2014 c\u00edlem l\u00e9\u010dby je funk\u010dn\u00ed sn\u00ed\u017een\u00ed frekvence a z\u00e1va\u017enosti, nikoli vyl\u00e9\u010den\u00ed. Pou\u017e\u00edvejte pod l\u00e9ka\u0159sk\u00fdm dohledem, pokud je to pot\u0159eba. Pokud jsou va\u0161e bolesti hlavy nov\u00e9, v\u00fdrazn\u011b odli\u0161n\u00e9 od obvykl\u00fdch, prov\u00e1zen\u00e9 hore\u010dkou, neurologick\u00fdmi deficity, ztuhlost\u00ed \u0161\u00edje nebo p\u0159ich\u00e1zej\u00ed s \"hromov\u00fdm\" n\u00e1stupem, vyhledejte neodkladnou l\u00e9ka\u0159skou p\u00e9\u010di \u2014 nejedn\u00e1 se o migr\u00e9nu.<\/em>","link":"https:\/\/medsbase.com\/cs\/anti-migraine\/","name":"L\u00e9\u010dba migr\u00e9ny","slug":"anti-migraine","taxonomy":"product_cat","parent":3223,"meta":[],"menu_order":0,"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3553","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/taxonomies\/product_cat"}],"up":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3223"}],"wp:post_type":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product?product_cat=3553"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}