The Intractables

Today I am unsure what to talk about. I have honestly not thought much about my blog this week. In weeks past I have attempted to blog several times during the week, but because I am now in the last few weeks of my semester at school time has been a bit of a luxury.

Surveys seem to be going well. I have posted a large amount of fliers on the second half of my school's campus and there seems to be a good response. The best way I have found to make sure surveys get done is to talk to people directly. If you are there with a computer they are a lot less likely to say they will do surveys and then never quite get around to it. Also I need to talk to my neighbors in my apartment complex. Direct communication there will also be helpful for making sure that surveys are being completed.

Like always a lot of thought has gone into picking the 'DotW' feature for this post. In the last few weeks at work we have had a large amount of kids who are sick with RSV or Bronchiolitis. Now it seems that those numbers are decreasing as the season for those illnesses is passing and we are getting our regular kids again.
Along with getting our regular patient load we have gotten patients who have severe headaches. One of the most common treatments that I have seen for intractable headaches is administration of a medication known as D.H.E. 45

So, this weeks feature shall be: D.H.E. 45, or dihydroergotamine mesylate
The organic molecule is:
Yes, that is a rather complicated molecule; lots of sights of possible action. For example the empirical formula, the most simple way of writing this thing down, is: C33H37N5O5·CH4O3S.

Needless to say the mechanism is a little complex. I would need about two years more neurological biology to fully understand it myself. There are two proposed ways in which this medication molecule functions to calm down headaches, or migraines - I know that migraines are different from normal headaches because I have suffered from them, but for the purposes of this blog we will just say they are the same as intractable headaches. The first is by neurological vaso-constriction - making the blood vessels in your brain smaller - and the second is by inhibiting the release of an inflammatory substance known as neuropeptide. D.H.E. 45 is administered through IV or through subcutaneous injections. There have been some heart complications and there have been no studies to determine what, if any, other long term effects this medication has on the body. For additional, and more complicated, explanations of this drug visit: http://www.drugs.com/pro/d-h-e-45.html

Personally, due to my experience with migraine headaches, I believe that this medication acts as a vaso-constrictor. Not for any medical reason, but because when I have taken drugs that act on that end of fixing the problem I have gotten better. Typically when I have seen D.H.E. 45 administered the child is in the hospital for about a week and they are kept in a dark quiet room over the length of their stay. Sometimes this is very successful, and sometimes it is not successful at all. Seems to be rather hit and miss in my opinion.