30 Drugs for headache 2023 An adult patient is admitted to the hospital with a severe migraine headache. The patient tells the nurse that he has been taking a nonsteroidal anti-inflammatory drug for pain. The nurse understands that the most appropriate drug for a patient with a severe migraine is which of the following drugs?
- Ibuprofen (Motrin)
- Propranolol (Inderal)
- Sumatriptan (Imitrex)
d. Verapamil (Calan) - Correct Answer ANS: C
Sumatriptan is the medication of choice to abort the severe pain of an actual migraine.Ibuprofen is used for mild to moderate pain and is not the drug of choice for severe migraine pain.Propranolol and verapamil are used as preventive therapy for migraines, not to abort the actual pain of a migraine.A patient is admitted to the emergency department for a severe migraine headache. The patient tells the nurse that she has used Cafergot (ergotamine tartrate and caffeine) for frequent migraine headaches over the past 6 months and has been experiencing numbness and tingling in the fingers and toes. The nurse should further assess the patient for which of the following signs and symptoms? (Select all that apply.)
- Diminished peripheral pulses
- Muscle aches
- Pallor of the extremities
- Nausea
e. Vomiting - Correct Answer ANS: A, B, C
Chronic use of Cafergot can lead to overdose, which should be suspected in this case because the patient has had frequent episodes of migraines and subsequent numbness and tingling in the fingers and toes. Overdose can cause ischemia secondary to constriction of peripheral arteries and arterioles, which can cause the extremities to become cold, pale, and numb. Muscle pain develops, and gangrene eventually may result.Nausea and vomiting are side effects, not the effects of a possible overdose of Cafergot.A nurse is providing community education on headaches. A member of the audience who has a history of migraines asks if a medication is available that will prevent attacks. The nurse's best response would be to identify which medication as preventive therapy for migraines? 1 / 2
- Propranolol (Inderal)
- Sumatriptan (Imitrex)
- Ergotamine (no trade name)
d. Dihydroergotamine (D.H.E.) - Correct Answer ANS: A
Beta blockers such as propranolol are the preferred drugs for migraine prevention. Treatment can reduce the number and intensity of attacks in approximately 70% of patients.Sumatriptan, ergotamine, and dihydroergotamine all are indicated to abort ongoing migraines, not prevent them.A patient has been prescribed propranolol (Inderal) for migraine headaches. The patient asks the nurse how the medication works. Select the nurse's most appropriate response for this medication's benefits.
- This medication can reduce the number and intensity of migraine attacks.
- This medication can abort an acute migraine attack.
- This medication is more effective in women than in men.
- This medication is especially useful in treating menstrual migraines. - Correct Answer ANS: A
- Does the patient have a family history of migraines?
- Has the patient taken ergotamine in the past 24 hours?
- Has the patient taken acetaminophen in the past 3 hours?
Propranolol can reduce the number and intensity of attacks in approximately 70% of patients, but it does not abort acute attacks.Propranolol is a preventive treatment for migraines, not an abortive treatment.Propranolol is not more effective in women than men as a preventive treatment for migraines.Menstrual migraines are more effectively managed with estrogen therapy, because they are hormone induced A prescriber orders sumatriptan (Imitrex) for a patient for a migraine headache. Prior to administration of this drug, it would be important for the nurse to gather which vital assessment information?
d. Is the patient allergic to sulfa compounds? - Correct Answer ANS: B
Sumatriptan, other triptans, and ergot alkaloids all cause vasoconstriction and should not be combined, or excessive and prolonged vasospasm could result. Sumatriptan should not be used within 24 hours of an ergot derivative and another triptan.A family history is important, but it is not vital assessment data as it relates to this scenario.
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