A young girl complains of episodic headaches preceded by fortification spectra. Each episode
last for 2-3 days. During headache pt prefers quiet, dark room. What is the tx of choice for acute
stage?
a. Paracetamol
b. Aspirin
c. Sumatriptan
d. Gabapentin
e. Cafergot
answer B
Management of migraine
• avoid triggers
• mild to moderate migraine
ƒ 1st line: NSAIDs (asprin, ketoprofen, ibuprofen, naproxen)
• moderate to severe migraine
ƒ triptans (most effective), ergots (dihydroergotamine, DHE)
• migraine prophylaxis:
1st line: propranolol, TCA (amitryptiline, nortriptyline), calcium channel blocker (verapamil), topiramate
2nd line: valproate, pizotefn, gabapentin
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