the ability to reduce cerebral blood flow not only through modulation of nitric oxide pathways but also via intracranial precapillary vasoconstriction. Indometacin property of reducing cerebral blood flow is useful in treating raised intracranial pressure. A case report has shown that an intravenous bolus dose of indometacin given with 2 hours of continuous infusion is able to reduce intracranial pressure by 37% in 10 to 15 minutes and increases cerebral perfusion pressure by 30% at the same time. This reduction in cerebral pressure may be responsible for the remarkable efficacy in a group of headaches that is referred to as "indometacin-responsive headaches", such as idiopathic stabbing headache, chronic paroxysmal hemicranial, and exertional headaches. On the other hand, the activation of superior salivary nucleus in the brainstem is used to stimulate the trigeminal autonomic reflex arc, causing a type of headache called trigeminal autonomic cephalgia. Indometacin inhibits the superior salivatory nucleus, thus relieving this type of headache. Prostaglandins also cause uterine contractions in pregnant women. Indometacin is an effective tocolytic agent, able to delay premature labor by reducing uterine contractions through inhibition of prostaglandin synthesis in the uterus and possibly through calcium channel blockade. Indometacin readily crosses the placenta and can reduce fetal urine production to treat polyhydramnios. It does so by reducing renal blood flow and increasing renal vascular resistance, possibly by enhancing the effects of vasopressin on the fetal kidneys. Other modes of action for indometacin are: it inhibits motility of polymorphonuclear leukocytes, similar to colchicine it uncouples oxidative phosphorylation in cartilaginous (and hepatic) mitochondria, like salicylates it has been found to specifically inhibit MRP (multidrug resistance proteins) in murine and human cells Nomenclature Indometacin is the , , and of the drug while indomethacin is the , and former and . See also Indometacin farnesil Indometacin morpholinylamide Pravadoline GW-405,833 References External links Effects of Perinatal Indomethacin Treatment on Preterm Infants, academic dissertation (PDF) Indomethacin, from MedicineNet Indomethacin, from Drugs.com Indocin: Description, chemistry, ingredients, from RxList.com 3α-Hydroxysteroid dehydrogenase inhibitors Antigout agents Carboxamides Chloroarenes Hepatotoxins Indole ethers at the benzene ring Nonsteroidal anti-inflammatory drugs Tocolytics Aromatic ketones Methoxy compounds