Migraine_Flashcards
What should be assessed in patients with migraine?
Assess the severity and frequency of attacks, and the impact on the patient’s life: quality of attacks, timing and frequency, possible causes, and general health in between attacks.
How long should a headache diary be used to identify triggers?
A headache diary should be used for a minimum of 8 weeks to identify triggers.
What is the first step in managing a migraine?
Simple analgesia (paracetamol or ibuprofen) is the first step in managing a migraine.
What is the second step in managing a migraine if simple analgesia is not effective?
Nasal sumatriptan is the second step if simple analgesia is not effective.
Why are oral triptans not recommended for people under 18 years?
Oral triptans are not licensed for people under 18 years due to safety concerns.
What is the third step in managing a migraine if nasal sumatriptan is not effective?
Combination therapy with nasal triptan and NSAID/paracetamol is the third step if nasal sumatriptan is not effective.
What anti-emetics can be considered in combination therapy for migraines?
Consider adding anti-emetics such as metoclopramide or prochlorperazine in combination therapy.
When should follow-up be arranged after starting migraine management?
Follow-up should be arranged within 1 month, but the patient should return sooner if symptoms get worse.
What prophylactic treatments are offered for migraines?
Topiramate or propranolol are offered as prophylactic treatments for migraines, with specialist referral required.
What is the risk associated with topiramate in migraine prophylaxis?
Topiramate has a risk of foetal malformations.
