{"id":10011,"date":"2011-06-30T18:00:00","date_gmt":"2011-06-30T18:00:00","guid":{"rendered":""},"modified":"2011-06-30T18:00:00","modified_gmt":"2011-06-30T18:00:00","slug":"skausmo-medicina-skausmo-rusys-ir-galvos-skausmai","status":"publish","type":"post","link":"https:\/\/www.pasveik.lt\/lt\/naujausi-medicinos-straipsniai\/skausmo-medicina-skausmo-rusys-ir-galvos-skausmai\/10011\/","title":{"rendered":"Skausmo medicina: skausmo r\u016b\u0161ys ir galvos skausmai"},"content":{"rendered":"<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">I. Pirminis galvos skausmas <o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Galvos skausmas &ndash; vienas da\u017eniausi\u0173<b> <\/b>negalavim\u0173, ver\u010dian\u010di\u0173 pacientus<b> <\/b>kreiptis pagalbos \u012f gydytoj\u0105. Tarptautin\u0117<b> <\/b>galvos skausmo draugija (IHS) galvos<b> <\/b>skausm\u0105 skirsto \u012f pirmin\u012f ir antrin\u012f.<b><o:p><\/o:p><\/b><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; Pirminiu vadinamas galvos skausmas, nesusij\u0119s su kitomis ligomis ar b\u016bkl\u0117mis.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; Antriniu vadinamas egzogenini\u0173 prie\u017eas\u010di\u0173 sukeltas galvos skausmas.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Pirminis galvos skausmas da\u017eniausiai b\u016bna labiau varginantis, labiau sutrikdo paciento biosocialin\u012f funkcionavim\u0105 ir pablogina gyvenimo kokyb\u0119 negu antrinis.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Prie\u017eastys<o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Pirminio skausmo prie\u017eastys ir j\u0173 da\u017enis (proc.):<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; <a href=\"https:\/\/pasveik.lt\/ligos-ir-sindromai\/<a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/migrena\/4394\">migrena<\/a>\/4394&#8243;>Migrena<\/a> 16<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; \u012etampos galvos skausmas 69<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; Idiopatinis 2<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; \u012etampos 1<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; Klasterinis 0,1<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Galvos skausmas da\u017eniausiai atsiranda d\u0117l dviej\u0173 patogenezini\u0173 mechanizm\u0173:<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; periferini\u0173 nociceptori\u0173 stimuliacijos, dirginimo (audini\u0173 pa\u017eeidimo, edemos, u\u017edegimo, spaudimo ir kt.);<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; skausmo signalus generuojan\u010di\u0173 strukt\u016br\u0173 ar laid\u0173 periferin\u0117je arba centrin\u0117je nerv\u0173 sistemoje pa\u017eeidimo ar neadekvataus aktyvinimo.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Pirminio galvos skausmo mechanizmai<o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Pirmin\u012f galvos skausm\u0105 da\u017eniausiai sukelia \u0161i\u0173 strukt\u016br\u0173 pa\u017eeidimas ar disfunkcija:<o:p><\/o:p><\/span><\/p>\n<ul style=\"margin-top: 0cm\" type=\"disc\">\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">did\u017ei\u0173j\u0173 intrakranijini\u0173 kraujagysli\u0173 ir kietojo dangalo;<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">tri\u0161akio nervo periferini\u0173 segment\u0173, inervuojan\u010di\u0173 \u0161ias strukt\u016bras;<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">tri\u0161akio nervo branduolio kaudalin\u0117s dalies, pereinan\u010dios \u012f nugaros smegen\u0173 kaklo srities dorsalinius ragus, o toliau &ndash; \u012f 1 ir 2 kaklini\u0173 nerv\u0173 \u0161akneles (vadinamasis trigeminocervikalinis segmentas).<o:p><\/o:p><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Pirminio galvos skausmo patogenezei labai svarbus tri\u0161akis nervas (<i>nervus<\/i> <i>trigeminus<\/i>), inervuojantis did\u017ei\u0105sias intrakranijines kraujagysles ir kiet\u0105j\u012f smegen\u0173 dangal\u0105 (vadinam\u0105j\u0105 trigeminovaskulin\u0119 sistem\u0105). Esant trigemininei autonominei cefalgijai, pacient\u0105 vargina a\u0161arojimas ir nosies u\u017egulimas. \u0160io tipo cefalgijoms priskiriamas klasterinis, migreninis skausmas ir paroksizmin\u0117 hemikranija.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/migrena\/4394\">Migrena<\/a> ir kiti pirminiai galvos skausmai n\u0117ra kraujagyslin\u0117s kilm\u0117s, jie n\u0117ra susij\u0119 su galvos kraujagysli\u0173 poky\u010diais, o j\u0173 gydymo veiksmingumas nepriklauso nuo vaist\u0173 poveiki\u0173 kraujagysl\u0117ms.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Pirminio galvos skausmo tipai<o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/migrena\/4394\">Migrena<\/a>. Tai antroji pagal da\u017en\u012f galvos skausmo prie\u017eastis. <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/migrena\/4394\">Migrena<\/a> serga apie 15 proc. moter\u0173 ir 6 proc. vyr\u0173.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">\u0160iai ligai b\u016bdingi epizodi\u0161ki, pasikartojantys galvos skausmai. Kartu gali b\u016bti \u0161viesos ir garso baim\u0117, pykinimas, v\u0117mimas. Paciento savijauta blog\u0117ja kei\u010diant k\u016bno pad\u0117t\u012f.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Migrenin\u012f skausm\u0105 sustiprina ar provokuoja ry\u0161ki \u0161viesa, garsas, stiprios emocijos, a\u0161trus kvapas ir kt. Migreniniam skausmui b\u016bdingi lydimieji simptomai, pasirei\u0161kiantys daugumai pacient\u0173:<o:p><\/o:p><\/span><\/p>\n<ul style=\"margin-top: 0cm\" type=\"disc\">\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">pykinimas (87 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">fotofobija ( 82 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">mirguliavimas akyse (72 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">vir\u0161ugalvio skausmingumas (65 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">v\u0117mimas (56 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">reg\u0117jimo sutrikimai (36 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">parestezijos (33 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/galvos-svaigimas\/65878\">galvos svaigimas<\/a> (<i>vertigo<\/i>) (33 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/samones-sutrikimai\/43837\">s\u0105mon\u0117s sutrikimai<\/a> (18 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/viduriavimas-2\/72707\">viduriavimas<\/a> (16 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">sinkop\u0117s (10 proc.);<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">traukuliai (4 proc.).<o:p><\/o:p><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Migrenos patogenez\u0117 sud\u0117tinga. Ji susijusi su monoaminergin\u0119 sensorin\u0119 sistem\u0105, esan\u010di\u0105 smegen\u0173 kamiene ir gumbure (<i>thalamus<\/i>), kontroliuojan\u010di\u0173 strukt\u016br\u0173 disfunkcija. Farmakologiniai tyrimai parod\u0117, kad migreninio skausmo patogenez\u0117s procesuose aktyviai dalyvauja neurotransmiteris serotoninas (5-hidroksitriptaminas, 5-HT). Prie\u0161 penkis de\u0161imtme\u010dius migrenai gydyti buvo prad\u0117ti vartoti skalsi\u0173 alkaloidai (metisergidas), slopinantys periferinius serotonino poveikius.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Dabartiniu metu <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/migrena\/4394\">migrena<\/a> labai veiksmingai gydoma triptanais &ndash; tai vaistai, selektyviai stimuliuojantys 5-HT receptori\u0173 subpopuliacijas. Triptanai aktyviausiai stimuliuoja 1B, 1D, ir 1F, o silpniau 1A 5-HT receptorius.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Kai kuri\u0173 tip\u0173 migreninio skausmo atsiradimui svarbus ir kitas neurotransmiteris &ndash; dopaminas.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Migrenos diagnostikos kriterijai<o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><a href=\"https:\/\/pasveik.lt\/ligos-ir-sindromai\/<a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/migrena\/4394\">migrena<\/a>\/4394&#8243;>Migrenai<\/a> b\u016bdingos pasikartojantys galvos skausmo priepuoliai, trunkantys 4&ndash;72 val., pasirei\u0161kiantys pacientams, kuri\u0173 somatin\u0117 b\u016bkl\u0117 normali ir nenustatoma kitoki\u0173 galvos skausmo prie\u017eas\u010di\u0173. Be to:<o:p><\/o:p><\/span><\/p>\n<ul style=\"margin-top: 0cm\" type=\"disc\">\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">nustatomi ma\u017eiausiai 2 i\u0161 \u0161i\u0173 simptom\u0173: vienos galvos pus\u0117s skausmas; pulsuojantis galvos skausmas; skausmas sustipr\u0117ja nuo fizinio ar emocinio kr\u016bvio, \u012ftampos, k\u016bno judesi\u0173;<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l0 level1 lfo3; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">nustatoma papildomai dar bent 1 i\u0161 \u0161i\u0173 simptom\u0173: \u0161leik\u0161tulys, pykinimas, v\u0117mimas; fotofobija ir fonofobija.<o:p><\/o:p><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Migren\u0105 reikia atskirti nuo da\u017eniausiai pasitaikan\u010dios pirminio galvos skausmo formos &ndash; \u012ftampos galvos skausmo. Kartais <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/migrena\/4394\">migrena<\/a> b\u016bna beskausm\u0117: ji pasirei\u0161kia pasikartojan\u010dia neurologine simptomatika, pykinimu, v\u0117mimu, svaigimu.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Migrenos gydymas<o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<ul style=\"margin-top: 0cm\" type=\"disc\">\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Nefarmakologin\u0117s priemon\u0117s: miego, darbo, poilsio re\u017eimas; skausmo trigeri\u0173 vengimas; joga, hipnoz\u0117, transcendentin\u0117 meditacija. Nefarmakologin\u0117s priemon\u0117s padeda daliai pacient\u0173 ir neapsaugo nuo vis\u0173 ligos priepuoli\u0173.<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Priepuolio (priepuolio) kupiravimas, gydymas. Gydym\u0105 reikia prad\u0117ti kuo grei\u010diau. Efektyv\u016bs nesteroidiniai vaistai nuo u\u017edegimo (pasirinktiniai &ndash; greitos veikimo prad\u017eios, turintys injekcin\u0119 form\u0105, kaip antai deksketoprofenas), triptanai, dopamino receptori\u0173 antagonistai. Vis\u0173 triptan\u0173, selektyvi\u0173 serotonino receptori\u0173 agonist\u0173, poveikio mechanizmas pana\u0161us, ta\u010diau farmakokinetika ir klinikinis veiksmingumas skiriasi. Triptanai ma\u017eiau veiksmingi esant migrenai su aura. Geriau toleruojami l\u0117\u010diau veikiantys, ilgesn\u012f eliminacijos pusperiod\u012f turintys triptanai (frovatriptanas).<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">\u012etampos galvos skausmas Tai l\u0117tinio galvos skausmo sindromas, pasirei\u0161kiantis abiej\u0173 galvos pusi\u0173 skausmu, diskomfortu, primenan\u010diu ver\u017eim\u0105 dir\u017eu. \u012etampos skausmas prasideda pama\u017eu, b\u016bna kintamo stiprumo (fliuktuoja), gali t\u0119stis daug dien\u0173.<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Galvos skausmas gali b\u016bti epizodinis arba l\u0117tinis (jei vargina daugiau kaip 15 dien\u0173 per m\u0117nes\u012f). Nuo migrenos \u012ftampos galvos skausmas skiriasi tuo, kad pastarojo nelydi migrenai b\u016bdingi simptomai &ndash; \u0161leik\u0161tulys, pykinimas, v\u0117mimas, fotoir fonofobija, osmofobija, skausmas nepulsuojantis, nesustipr\u0117ja nuo k\u016bno judesi\u0173. Jei \u012ftampos galvos skausmas pasirei\u0161kia su <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/migrena\/4394\">migrena<\/a> (gana da\u017enai), triptan\u0173 poveikis yra labai geras.<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Autonomin\u0117s <i>nervus trigeminus <\/i>cefalgijos<i> Klasterinis skausmas<\/i>. Tai labai reta<i> <\/i>pirminio galvos skausmo forma (pasitaiko<i> <\/i>apie 0,1 proc. populiacijos).<i> <\/i>B\u016bdingiausias klasterinio skausmo<i> <\/i>bruo\u017eas &ndash; jo periodi\u0161kumas. Skausmas<i> <\/i>da\u017enai prasideda nakt\u012f (apie 50 proc.<i> <\/i>ligoni\u0173), kartojasi kasdien pana\u0161iai tuo<i> <\/i>pa\u010diu metu (vienas du priepuoliai per<i> <\/i>par\u0105), priepuoli\u0173 trukm\u0117 nedidel\u0117.<i><o:p><\/o:p><\/i><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt 18pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Priepuolio gydymas<\/span><\/i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">. Klasterinio skausmo priepuol\u012f mal\u0161ina deguonies inhaliacijos. Labai veiksmingi triptanai.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt 18pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Paroksizmin\u0117 hemikranija. <\/span><\/i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Ji pasirei\u0161kia da\u017enais (daugiau negu penki priepuoliai per dien\u0105) stipraus trumpai trunkan\u010dio (2&ndash;45 min.) vienos galvos pus\u0117s skausmo epizodais. Gydoma nesteroidiniais vaistais nuo u\u017edegimo.<o:p><\/o:p><\/span><\/p>\n<ul style=\"margin-top: 0cm\" type=\"disc\">\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Be \u0161i\u0173 pla\u010diau apra\u0161yt\u0173 galvos skausmo form\u0173, i\u0161skiriama: l\u0117tinis kasdieninis skausmas (jei galv\u0105 skauda daugiau negu 15 dien\u0173 per m\u0117nes\u012f), medikamentinis galvos skausmas, potrauminis skausmas, nuolatin\u0117 hemikranija, pirminis duriantis skausmas, pirminis seksualinio aktyvumo sukeliamas skausmas, miego galvos skausmas ir kt.<o:p><\/o:p><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Frovatriptanas<o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Triptanai &ndash; naujausia galvos skausmui gydyti skirt\u0173 vaist\u0173 klas\u0117. Triptanais dabartiniu metu veiksmingai gydomas migreninis ir <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/klasterinis-galvos-skausmas\/4392\">klasterinis galvos skausmas<\/a>. Triptanai migrenin\u012f skausm\u0105 slopina veikdami patogenezi\u0161kai &ndash; stimuliuodami selektyviai serotonino receptori\u0173 subpopuliacijas, atsakingas u\u017e galvos skausm\u0105.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Nors triptanai labai veiksmingai mal\u0161ina migreninio skausmo priepuol\u012f, nuolat juos vartojant, priepuoli\u0173 netgi gali pada\u017en\u0117ti. \u0160is nepageidaujamas poveikis b\u016bdingesnis trumpesnio poveikio (greitesn\u0117s eliminacijos) triptanams.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Frovatriptanas i\u0161siskiria pa\u010dia ilgiausia i\u0161 vis\u0173 triptan\u0173 veikimo trukme (jo pusin\u0117s eliminacijos periodas sudaro 25 val., taigi yra keturis kartus ilgesnis negu kit\u0173 triptan\u0173), ma\u017eu lipofili\u0161kumu, ma\u017eu biologiniu prieinamumu vartojant per os (24&ndash;30 proc.).<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Frovatriptanas u\u017etikrina ilgiausiai trunkant\u012f antimigrenin\u012f poveik\u012f ir ilgiau bei patikimiau nei kiti triptanai apsaugo nuo galvos skausmo pasikartojimo.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Klinikiniai tyrimai parod\u0117, kad daugumai pacient\u0173, pavartojus 2,5 mg (nedidel\u0119 doz\u0119) frovatriptano, migrenos priepuolio simptomai visi\u0161kai i\u0161nyksta arba labai susilpn\u0117ja.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Frovatriptanas efektyviai slopina ne tik galvos skausm\u0105, bet ir kitus migrenos simptomus: \u0161leik\u0161tul\u012f, pykinim\u0105, v\u0117mim\u0105, galvos svaigim\u0105, \u0161viesos ir garso baim\u0119. Gydymas frovatriptanu 35 proc. <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/migrena\/4394\">migrena<\/a> sergan\u010di\u0173 pacient\u0173 \u012fvertintas kaip labai veiksmingas arba veiksmingas. Per 2 val. migrenin\u012f skausm\u0105 2,5 mg frovatriptano numal\u0161ino 46 proc. pacient\u0173 (placebas 21&ndash;27 proc.), o per 4 val. &ndash; 65 proc. pacient\u0173.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Klinikiniai tyrimai parod\u0117, kad frovatriptanas yra vienas aktyviausi\u0173 antimigrenini\u0173 vaist\u0173: jis veiksmingai numal\u0161ina netgi tok\u012f migrenin\u012f skausm\u0105, kurio neveikia acetaminofenas, aspirinas ir nesteroidiniai vaistai nuo u\u017edegimo.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">II. Kaklo ir peties skausmas<o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Kaklo ir sprando skausmu, epidemiologini\u0173 tyrim\u0173 duomenimis, skund\u017eiasi apie 4,6 proc. suaugusi\u0173 \u017emoni\u0173. Da\u017eniausiai kaklo skausm\u0105 sukelia stuburo cervikalin\u0117s dalies ir kaklo mink\u0161t\u0173j\u0173 audini\u0173 pa\u017eeidimai.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Da\u017eniausios kaklo skausmo prie\u017eastys:<o:p><\/o:p><\/span><\/p>\n<ul style=\"margin-top: 0cm\" type=\"disc\">\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Cervikalini\u0173 disk\u0173 ligos. Apatinio cervikalinio disko herniacija (i\u0161var\u017ea) yra da\u017ena kaklo, peties, rankos ir pla\u0161takos skausmo ir dilg\u010diojimo prie\u017eastis. Diskogeninis skausmas sustipr\u0117ja tiesiant ir sukant kakl\u0105 (galv\u0105) \u012f \u0161on\u0105, nes tuomet siaur\u0117ja intervertebralin\u0117 anga, ry\u0161k\u0117ja \u0161akneliniai simptomai (Spurlingo po\u017eymis).<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Stuburo kaklo dalies spondilioz\u0117. Stuburo cervikalin\u0117s dalies osteoartritas sukelia kaklo skausm\u0105, plintant\u012f \u012f pakau\u0161\u012f, pe\u010dius, rankas, gali b\u016bti pasikartojan\u010di\u0173 ar nuolatini\u0173 galvos skausm\u0173 prie\u017eastis. Lhermitto simptomas (palenkus galv\u0105, atsiranda elektros srov\u0117s poj\u016btis, &bdquo;srov\u0117&rdquo; plinta \u017eemyn nuo kaklo per nugar\u0105).<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Esant kaklin\u0117s stuburo dalies pa\u017eeidim\u0173, neurogenini\u0173 simptom\u0173 gali b\u016bti vien tik&hellip; kojose.<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Kitos ligos ir pa\u017eeidimai, sukeliantys kaklo ir sprando skausm\u0105: <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/reumatoidinis-artritas\/4307\">reumatoidinis artritas<\/a> (cervikalini\u0173 apofizini\u0173 s\u0105nari\u0173), ankilozinis spondilitas, v\u0117\u017eio metastaz\u0117s \u012f stubur\u0105, infekcijos (epidurinis abscesas, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/osteomielitas\/72020\">osteomielitas<\/a>), metabolin\u0117s kaul\u0173 ligos (<a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/osteoporoze\/4312\">osteoporoz\u0117<\/a> ir kt.). Kartais \u012f kakl\u0105 iradijuoja koronariniai skausmai.<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Kr\u016btin\u0117s l\u0105stos vir\u0161utin\u0117s atvaros sindromas. Jis pasirei\u0161kia pla\u0161takos medialini\u0173 raumen\u0173 silpnumu, susilpn\u0117jusiais delno jutimais ties 4 ir 5 pir\u0161tais.<o:p><\/o:p><\/span><\/li>\n<li style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Peties skausm\u0105 gali sukelti <i>plexus brachialis <\/i>arba periferinio nervo su\u017ealojimas,<i> <\/i>infekcija, navikin\u0117 infiltracija.<i><o:p><\/o:p><\/i><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Gydymo principai ir priemon\u0117s<o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\"><o:p>&nbsp;<\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Gydoma analgetikais, nesteroidiniais vaistais nuo u\u017edegimo, esant neuropatinio ar mi\u0161raus skausmo komponentui, &ndash; antidepresantais arba antikonvulsantais (vaistais nuo epilepsijos), fizin\u0117s medicinos, kartais ir psichoterapijos priemon\u0117mis. Klinikin\u0117je praktikoje, be u\u017edegim\u0105 slopinan\u010dio aktyvumo, labai svarbios ir tokios NVNU charakteristikos, kaip vartojimo b\u016bdas, poveikio prad\u017eia ir trukm\u0117 ir kt.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Greita veikimo prad\u017eia ir nedidel\u0117 trukm\u0117 labai svarbios tuomet, kai:<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; reikia greitai numal\u0161inti stipr\u0173 ar vidutinio stiprumo skausm\u0105;<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; tik\u0117tina, kad skausmas greitai praeis, nes jo prie\u017east\u012f galima pa\u0161alinti (pvz., reponavus i\u0161nirus\u012f ar panirus\u012f s\u0105nar\u012f, kaulo l\u016b\u017egalius, drenavus p\u016blin\u012f ir pan.);<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; po operacijos.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Vienas aktyviausi\u0173 NVNU yra ketoprofenas, ta\u010diau tai vienas labiausiai gastroenterotoksi\u0161k\u0173 NVNU. Cheminiu po\u017ei\u016briu, ketoprofenas yra recemin\u0117 med\u017eiaga, sudaryta i\u0161 dviej\u0173 enantiomer\u0173:<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; farmakologi\u0161kai aktyvaus S (+) enantiomero deksketoprofeno ir<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; neaktyvaus R (-) enantiomero.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Nustatyta, kad ulcerogeni\u0161kai veikia b\u016btent neaktyvusis, balastinis, R (-) enantiomeras. Mokslininkams pavyko i\u0161 raceminio mi\u0161inio ketoprofeno i\u0161skirti, i\u0161gryninti veikl\u0173j\u012f S (+) enantiomer\u0105 deksketoprofeno.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Deksketoprofenas cheminiu po\u017ei\u016briu yra laisva organin\u0117 r\u016bg\u0161tis, jos absorbcija i\u0161 vir\u0161kinamojo trakto l\u0117tesn\u0117 negu raceminio mi\u0161inio ketoprofeno. Deksketoprofeno absorbcija reik\u0161mingai pager\u0117jo, suk\u016brus jo trometamolio drusk\u0105.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Deksketoprofeno trometamolis (kapsul\u0117s) panoksta racemin\u012f ketoprofen\u0105 daugeliu svarbi\u0173 farmakokinetikos charakteristik\u0173:<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; daug saugesnis ir geriau toleruojamas;<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; grei\u010diau ir net 100 kart\u0173 geriau rezorbuojamas i\u0161 vir\u0161kinamojo trakto;<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; grei\u010diau pasiekiama maksimali koncentracija plazmoje;<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">&bull; maksimali veikliosios med\u017eiagos koncentracija plazmoje b\u016bna reik\u0161mingai didesn\u0117 negu vartojant ketoprofen\u0105.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Deksketoprofenas pasi\u017eymi dvejopu &ndash; centriniu ir periferiniu &ndash; analgetiniu poveikiu, slopina u\u017edegim\u0105, edem\u0105, suma\u017eina periferin\u0119 nerv\u0173 laid\u0173 ir receptori\u0173 sensitizacij\u0105 (jaudrum\u0105).<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Deksketoprofeno u\u017edegim\u0105 slopinantis ir analgetinis poveikis bei saugumas i\u0161samiai tyrin\u0117ti daugiau kaip 35 klinikini\u0173 tyrim\u0173 metu. \u0160iuose tyrimuose dalyvavo 6,38 t\u016bkst. pacient\u0173, i\u0161 j\u0173 3,38 t\u016bkst. vartojo deksketoprofen\u0105: 2,27 t\u016bkst. buvo gydomi geriamuoju, o 1,11 t\u016bkst. &ndash; injekciniu deksketoprofenu.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Tyrimai parod\u0117, kad deksketoprofenas skausm\u0105 ir u\u017edegim\u0105 slopino ne ma\u017eiau negu kiti NVNU, be to, daugeliu atvej\u0173 veik\u0117 grei\u010diau. Deksketoprofenas yra vienas i\u0161 nedaugelio NVNU, turin\u010di\u0173 ir geriam\u0105j\u0105, ir injekcin\u0119 formas. Vokietijoje atlikti 5 atsitiktini\u0173 im\u010di\u0173 dvigubai akli klinikiniai tyrimai parod\u0117, kad deksketoprofenas efektyviai mal\u0161ina \u016bmin\u012f vidutinio stiprumo ar stipr\u0173 nugaros ir kaklo skausm\u0105. Gydant deksketoprofenu, per 4&ndash;7 dienas reik\u0161mingai suma\u017einamas arba pa\u0161alinamas staiga prasid\u0117j\u0119s kaklo ir nugaros skausmas daugumai pacient\u0173.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Deksketoprofenu efektyviai galima gydyti \u016bmin\u012f ar l\u0117tin\u012f pa\u016bm\u0117jus\u012f kaklo ir peties skausm\u0105: a\u0161tr\u0173 skausmo epizod\u0105 rekomenduojama greitai numal\u0161inti deksketoprofeno injekcijomis, paskui t\u0119sti palaikom\u0105j\u012f gydym\u0105 geriamuoju preparatu kelet\u0105 dien\u0173.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Geriamuoju arba injekciniu deksketoprofenu greitai ir efektyviai mal\u0161inamas migrenos priepuolis, klasterinio ar \u012ftampos skausmo epizodai. Tokiais atvejais greita veikimo prad\u017eia yra reik\u0161mingas deksketoprofeno prana\u0161umas, palyginti su kitais NVNU.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt\" lang=\"EN-GB\"><o:p>&nbsp;<\/o:p><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt\" lang=\"EN-GB\"><a href=\"https:\/\/pasveik.lt\/<a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/migrena\/4394\">migrena<\/a>\/41420&#8243;>Migrenos testas<\/a><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\">&nbsp;<\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt\" lang=\"EN-GB\"><a href=\"https:\/\/pasveik.lt\/<a href=\"https:\/\/pasveik.lt\/lt\/vaistai\/testas\/5228\">testas<\/a>&#8212;galvos-skausmai\/61723&#8243;>Galvos skausm\u0173 testas<\/a><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\">&nbsp;<\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt\" lang=\"EN-GB\"><a href=\"https:\/\/pasveik.lt\/?healthclub=9\">Migrenos klubas<\/a><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\">&nbsp;<\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt\" lang=\"EN-GB\"><a href=\"https:\/\/pasveik.lt\/video-pranesimai\/60480\">Video repota\u017eai<\/a><\/span><\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\">&nbsp;<\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\">&nbsp;<\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\">&nbsp;<\/p>\n<p style=\"text-align: justify; margin: 0cm 0cm 0pt\" class=\"MsoNormal\">&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Galvos skausmas &ndash; vienas da\u017eniausi\u0173<b> <\/b>negalavim\u0173, ver\u010dian\u010di\u0173 pacientus<b> <\/b>kreiptis pagalbos \u012f gydytoj\u0105. Tarptautin\u0117<b> <\/b>galvos skausmo draugija (IHS) galvos<b> <\/b>skausm\u0105 skirsto \u012f pirmin\u012f ir antrin\u012f.<b><o:p><\/o:p><\/b><\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[27313],"tags":[924,1012,797,1598,3042,1224,736,85,148,1229,832,1169,53,112,21,177,3044,3045,3043,1151,138,727],"site":[],"post_item_type":[27345],"class_list":["post-10011","post","type-post","status-publish","format-standard","hentry","category-gydymo-naujienos","tag-deksketoprofeno","tag-disfunkcija","tag-eliminacijos","tag-galvos-skausmai","tag-hemikranija","tag-ketoprofenas","tag-klinikiniai-tyrimai","tag-miego","tag-migrena","tag-nesteroidiniai","tag-nvnu","tag-plastakos","tag-pykinimas","tag-serotonino","tag-sindromas","tag-skausmui","tag-sleikstulys","tag-sleikstulys-pykinimas","tag-subpopuliacijas","tag-svarbios","tag-vaistai","tag-veiksmingas"],"acf":{"post_sites":false},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/10011","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/comments?post=10011"}],"version-history":[{"count":0,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/10011\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=10011"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/categories?post=10011"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=10011"},{"taxonomy":"site","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/site?post=10011"},{"taxonomy":"post_item_type","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/post_item_type?post=10011"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}