Treatment of migraine given in ER


Every 10 seconds, someone in the United States is developing a migraine headache, so severe, go to the Hospital Emergency Room (ER), according to the Foundation Research of migraine. Given the pain and risks associated with these episodes (for example, uncontrollable vomiting), doctors often choose methods to treat migraine, which can be administered using injection or IV, so they can Have a quick effect.

Emergency treatment for migraine depends on the specific symptoms of general patients and health and background of health.Although this emergency treatment review of the headaches will give you an idea of the typical approaches used in ER, keep in mind that your concern may differ slightly from these standard protocols.

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When you seek attention

If you are dealing with migraine, it is useful to know that there are solutions, If they are once.Either so bad how to justify emergency care. But knowing it when seek this level of medical care is important.

If you describe your pain as your worst migraine attack (or headache), you should consider emergency care for the nearest hospital, advise the national base of headaches (NHF).

relative to symptoms

If your headache is accompanied by one of the following,The trip to the hospital is recommended according to NHF:

  • vision loss
  • uncontrollable vomiting
  • pain, which It lasts more than 72 hours with less than four solid relief symptoms
  • ,which are unusually for you or frightening
  • lustration

< Treatment approaches at ER

Treatment you can get in the emergency care department at the hospital for a painHead of migraine, it will be based on most, its symptoms and history of personal medical care. In other words, there is not a single size, all this is fixed.

however, there are are standards and recommendations .On the one hand, the medications that are shown in ER for the pain of the head of the migraine generally administer parenterally, except the mouth, including subcutaneous injection (only shot only below the skin),Intramuscularly (deeper injection in muscle tissue) and intravenously (through tube IV).

These methods allow medications to work faster in the body, and are more effective for those who experience so many nausea and / or vomiting that they maintain that the tablet is almost impossible.Many people also provide fluids through IV to prevent dehydration.

and 2016,The American Headache Society (AHS) collected a group of experts to consider clinical trials of many diverse medications used in emergencies for the treatment of migraine in adults to determine who really works better and is theSafer rejection group reviewed in research 28 different medications to create recommendations for the acute treatment of migraine in adults .

Linear procedures

Based on the results of 68 clinical trials, the AHS group determined that adults who attend ER for migraine pain and other symptoms,A three medications for pain and other symptoms should be proposed, especially nausea and vomiting:

  • metoclopramide , antimitis (anti-Nausea) Medications blocking dopamine receptors in the brain to relieve nausea and vomiting, as well as pain
  • swallowrazine, psychotic
  • Sumatriptan Selective sereotonin receptor agonist (SSRI), which limits blood vessels in the brain and blocks certain substances that cause pain relieving headaches,nausea and other migraine symptoms

panel also determined that adults with migraine should receive a dose of dexamethasone , a steroid that reduces the risk of being Repeat the migraine.

Treatment methods of the second line

If what’s why the first medications is not adequate,The panel found that the following alternatives can be offered:

  • acetaminofen , analgesic
  • Acetylsalicylic acid , aspirin
  • clorpromazine , anti-psicótico
  • ketoprofeno , fármaco antiinflamatorio de Nesteroid (NSAID)
  • diclofenac , nsaid
  • droperidol anti-Dopamic drug that eliminates nausea
  • haloperidol , anti-psicológico
  • ketorolac , nsaid
  • valproate , antiConvulsivamente, que no alivia las migrañas,but can help prevent the repetition of one

that are not recommended

between medications, which are commonly used in ER for the treatment of migraine headaches,They are the city that the group assumes that it should not be given because they do not work, as well as others or for other reasons. For example, the hydromorphone and morphine are the class of opioid drug associated with dependency.

In the AHS drug list, which are better avoiding for the treatment of migraine in ER:

  • diphenhydramine , antihistamine
  • Hydromorphone , opioid
  • Lidocaine ,Analgógico
  • auctions>,The medication is often delivered to the patient with cancer to control diarrhea

Caution for pregnant women

Some medications used in emergency processingMigraine headaches crosses the placenta of women, live and cause a possible damage to a developing child.These include:

  • nsaids: are not considered safe for women in the third trimester of pregnancy, during which these medications can interfere with the healthy development of lungs children,Cause low levels of amniotic fluid slowly or stop the workforce during childbirth.
  • dihydroergotamine: also known as Alcaloide Ergot, this medicine is in the long list of medications cited by Panel AHS,How to have very little information available to recommend or not recommend a woman for pregnancy. The names of the brand in this class include D.H.E. 45 and migranal.
  • opioids: oxycodon and morphine are opioid medications that have a high risk of abuse and addiction.Studies have shown that opioids are also less effective when completing migraine than antimitomethism, metoclopramide. .ValProate is considered highly necessary and is prohibited in many countries for use in pregnant women and fertile women.

Word of the recipient’s information of Meds

Migraine headache processing, which is heavy enough to require attention to emergency,It can be difficult. Many medications were used to relieve pain, nausea, vomiting and other symptoms more successfully than others.And, despite the AHS recommendations of the most efficient and insurance protocols to manage acute migraine in case of emergency, the patient’s treatment receives in a hospital, may differ from the proposal.

The most important thing to remember if you are going to ER for migraine (or any other emergency),This is what a defender should be for you or make sure you can fill this role with you, the refusal means to be direct and exhaustive when answering questions about your current health and any medication that you accept, including the exceeded products, including the exceeded products, includingAdditives and recreational preparations. Honesty will help doctors take care of you could perfect a migraine medicine, it is most likely that it is easier for your pain as quickly as possible.

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