There is a risk of headaches caused by medication withdrawal or medication overuse.Zolmitriptan has a weak affinity for 5-HT 1A receptors; these receptors have implications in the development of serotonin syndrome.Following administration of cimetidine, the half-life and AUC of zolmitriptan and its active metabolites were approximately doubled (see CLINICAL PHARMACOLOGY in product pamphlet). Contraindications
Zolmitriptan is contraindicated in patients with cerebrovascular or cardiovascular disease because 5-HT 1B receptors are present in coronary arteries. Such conditions include, but are not limited to, coronary artery disease, stroke, and peripheral vascular disease.It is also contraindicated in hemiplegic migraine. Mechanism of action
Zolmitriptan is a selective 5-hydroxytryptamine 1B/1D receptor agonist with a weak affinity for the 5-HT 1A receptor subtypes. Its action on 5-HT 1B/1D receptors causes vasoconstriction in intracranial blood vessels; as well it can inhibit the release of pro-inflammatory neuropeptides from trigeminal perivascular nerve endings. It crosses the blood-brain-barrier as evidenced by the presence of radioactive [3H]-zolmitriptan labels within the cells of the trigeminal nucleus caudalis and nucleus tractus solitaries. Pharmacokinetics
Zolmitriptan has a rapid onset of action and has been detected in the brain as early as within 5 minutes of intranasal administration. On average, zolmitriptan has an oral bioavailability of 40%, a mean volume of distribution of 8.3 L/kg after oral administration, and 2.4L/kg after intravenous administration.Zolmitriptan is metabolized into three major metabolites by the human hepatic cytochrome P450 enzymes—primarily CYP1A2.
This method consists of applying a piece of amniotic membrane to the ocular surface. Amniotic membrane patches are prepared from placental tissues from women who had a planned cesarean sections. AMT appears to be a useful therapy which results with stabilization of the ulcer progression and corneal epithelial defect healing. It is most likely, that amniotic membrane used as an ocular graft stop the inflammation process because of the expression of immunoregulatory molecules, including Fas ligand and HLA–G antigens. In addition, the amniotic membrane contains a large number of collagens, growth factors and protease inhibitors which can promote healing and reconstruction of the conjunctival epithelium.Other surgical interventions such as lamellar keratectomy, keratoepithelioplasty and corneal transplantation have also been reported as effective treatment options for Mooren’s ulcer. == References ==