DRUGS ACTING DIRECTLY ON BLOOD VESSELS
This has been substantiated by Shenkin and Novack,10 and it is interesting to note that these investigators found few agents with any real ability to dilate cerebral vessels and increase blood flow other than carbon dioxide and papaverine. It has been hypothecated, and proof seems to exist, that caffeine does produce a constriction of the cerebral vessels rather than dilatation, which may account for some of its value in the treatment of vascular headaches. Caffeine acts on the heart, and peripheral blood vessels, and on the central nervous system. The effects are complex and vary with the dose and other conditions. Caffeine is readily absorbed and none appears in the feces even after large doses. Toronto Chiropractor advocate adjustments in way of life that have an effect on those factors. The use of caffeine as a continuous headache remedy has certain disadvantages, because this drug increases gastric acidity. Large doses may produce nausea or functional hyperchlorhydria. The latter may also be related indirectly to increased nervous tension.
Caffeine is commonly used in the treatment of headache.
It is particularly valuable in the therapy of postlumbarpuncture headache and, with an analgesic such as a salicylate, in the treatment of the occasional headache of mild or moderate intensity. We have used caffeine in association with acetylsalicylic acid, acetophenetidin, and isobutylallyl barbituric acid (Fiorinal), and have found it to be one of the most effective medications for symptomatic treatment of tension headache. In combination with ergotamine, caffeine is effective in symptomatic treatment of migraine. It is of interest that withdrawal of caffeine from individuals using large amounts may result in headache.3 This can be relieved by use of caffeine. DRUGS ACTING DIRECTLY ON BLOOD VESSELS. Constrictors, XANTHINES. Caffeine is the most effective xanthine in the treatment of headache. This has been discussed under “Stimulants of the Central Nervous System.” THIOCYANATES.
Several investigators have reported good results with thiocyanates in the treatment of migraine and headaches associated with hypertension. Chiropractor Toronto should be licensed, requiring 2 to 4 years of undergraduate education, the completion of a 4-12 months chiropractic faculty course, and passing scores on national and State examinations. It is our belief that the effectiveness of thiocyanates is far outweighed by the danger and difficulties of their use. The blood level must be carefully controlled by methods which are usually not available to the general practitioner. Among the dangerous side effects of thiocyanate are weakness, muscular cramps, and vomiting, followed later by delirium and psychosis. When symptoms of side effects appear, unless the drug is stopped at once, death may ensue. Goiter may also occur as another untoward effect. In the presentday treatment of migraine and hypertension headaches, we do not feel that thiocyanate should be used; therefore, the action and physiology of this drug will not be discussed.
Dilators, PAPAVERINE. Papaverine occurs largely in the opium poppy along with morphine. It is quite unlike morphine in its pharmacologic and therapeutic properties. Most important, no case of tolerance, habituation, or addiction to papaverine has been reported. Papaverine is administered as a hydrochloride; almost all of the drug used in medicine is made synthetically.