Glavobolja uzrokovana prekomjerenim uzimanjem lijekova

master's thesis

• Title (english): Medication overuse headache
• Author: Dora Katalenac
• Mentor: Darija Mahović Lakušić (mentor)
• Committee member: Željka Petelin Gadže (predsjednik povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Committee member: Darija Mahović Lakušić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Glavobolja uzrokovana prekomjernim uzimanjem lijekova (engl. medication overuse headache – MOH) jedna je od najčešćih kroničnih glavobolja te se u svijetu pojavljuje s prevalencijom od 1-2% godišnje. Češće se pojavljuje u žena u četrdesetim godinama, niskog obrazovanja i socioekonomskog statusa.
MOH nastaje kao posljedica prekomjernog uzimanja analgetika koji se koriste u terapiji akutnih napadaja glavobolje. Prekomjerno uzimanje lijekova dovodi do kronifikacije glavobolje i povećanja frekvencije na 15 dana mjesečno ili pak više. Pacijenti s MOH-om obično se prezentiraju naglim pogoršanjem i promjenom obrasca glavobolje s povećanjem frekvencije. Svi analgetici mogu uzrokovati MOH, a najčešće su to kombinirani pripravci koji sadrže kodein ili kafetin i mogu se kupiti bez recepta te u razvijenim zemljama triptani. Terapija izbora za MOH ukidanje je prekomjerno uzimanog lijeka te ona kod većine pacijenata dovodi do povratka na prijašnji obrazac glavobolje.
U ovom će preglednom radu biti dan sažeti prikaz epidemiologije, patofiziologije, dijagnoze, kliničke slike, terapije te prognoze MOH-a. Budući da je ovo područje još uvijek nedovoljno istraženo i ne postoji zadovoljavajući broj pouzdanih studija, stručnjaci su podijeljeni po pitanju mehanizma nastanka MOH-a te najboljeg terapijskog pristupa pacijentu.

Abstract (english)

Medication overuse headache (MOH) is one of the most common chronic headache diseases in the world, with a yearly prevalence of 1-2%. It is more common in females in their forties, of low education and of lower socioeconomic status.
MOH develops as a result of the overuse of analgesics used in the treatment of acute attacks of headache. The overuse of medication leads to chronical headaches and to the increase of headache frequency, up to 15 or more days per month. MOH patients are usually presented with sudden worsening of headaches with change in the pattern of headaches and with an increase in frequency. All analgesics can cause MOH, but mostly it is caused by the analgesics containing codeine or caffetine purchased without prescription, and, in high developed countries, with triptans. Treatment of choice is a withdrawal of overused medication. In most patients, this treatment results in regress of the previous pattern of headaches.
In this study I am going to present the concise review of epidemiology, pathophysiology, diagnosis, clinical presentation, treatment and prognosis of MOH. Since this area is still insufficiently researched and there is no satisfactory amount of reliable clinical studies, the experts are divided on the issue of development of MOHs pathogenesis and the best therapeutic approach to the patient. In this study I shall present the latest findings related to MOH as well as the guidelines that are used in daily practice.

• Keywords: glavobolja uzrokovana prekomjernim uzimanjem lijekova; migrena; kronična glavobolja; analgetici; ovisnost
• Keywords (english): medication overuse headache; migraine; chronic headache; analgesics; dependance
• Language: croatian
• URN:NBN: urn:nbn:hr:105:199958
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-06-16 09:17:18