"Migraine Headache Treatment" is an excellent example of a paper on drug therapy. Based on the assessment, Toni is suffering from migraine headaches. This condition is making her miss work thereby leading to a decreased quality of life. The migraines associated with her menses tend to be the most lasting and severe. Based on the symptoms, Toni’ s migraines occur at a period of severe hormonal fluctuation; showing a connection between her sex hormones and migraine headache pain. Toni is suffering from menstrual migraine, and her headaches occur as per the menstrual cycle although she has headaches at other times as well.
It should be noted that migraine headaches cannot be cured but managed. Question 1 The medications of choice are Frova, which has to be taken orally as soon as the migraine commences, and Magnesium 400 mg/d (Silberstein et al. , 2004). Frova falls in the class of Serotonin-1b and Serotonin-1d Receptor Agonist. I chose this drug as it contains the ideal pharmacologic action as compared to the other classes, based on the patient’ s symptoms. This medication acts by narrowing the blood vessels.
Thus, it stops pain signals from being relayed to the brain. Therefore, the release of natural substances that cause pain and other migraine symptoms are blocked (MacGregor et al. , 2009). Magnesium 400 mg/d has been reported to be effective in migraine treatment. Question 2 Non- pharmacologic measures include educating the patient. They are: Avoidance of trigger foods i. e. red wine, chocolate, aged cheese Reduction of stress, anxiety, depression by following a stress management therapy Indulging into a regular practice of relaxation i. e. getting enough sleep, healthy diet plans, regularly exercise Consult a doctor if any of the signs present themselves i. e.
severe abrupt headaches, double vision Keeping a headache diary to determine what triggers the migraines Question 3 Potential side effects of Frova include tiredness, headache (not a migraine headache), dizziness, paresthesia, hot or cold sensation, dry mouth, hot flashes, dyspepsia, fatigue, chest pain, indigestion, joint pain, and tingling feeling. These symptoms can be managed, and they wear off with time. However, if they persist, the doctor should be alerted immediately. Worst-case scenarios include stroke, high blood pressure, and serious heart problems. If these occur, the medication should be stopped immediately, and the patient should visit the nearest health facility immediately. Question 4 Potential drug interactions for Frova include an increase in serotonin syndrome/ toxicity if other drugs are being administered that increase serotonin.
I. e. ecstasy, fluoxetine, St. John’ s wort, venlafaxine. Ergot contacting drugs have been shown to cause prolonged vasospastic reactions. This patient must not take any other drugs combined with Frova, and if need be, the other drugs may be taken 24 apart from the administration of Frova (Buchan et al. , 2002; Buchan et al. , 2002). Question 5 I selected the brand name is Frova.
The generic name is Frovatriptan. No, there is no generic version of Frova available for sale currently. I could prescribe a generic preparation as generic preparations are affordable as compared to brand versions. Due to the generic version not being available, I have prescribed a branded version. Question 6 Frova tablet 2.5 mg is $37 per pill. This drug cannot be compared with other options since there is no generic brand version of it. This medication is not in the $4 list available at area stores. Question 7 To know if the medication is working, an ID migraine screening test is done.
The patient is required to fill a headache diary and bring it to the two-month follow-up visit. The working of the drug will be evident from the headache diary. That is the headache frequency and occurrence. I would know if the medication is efficacious by expecting a decrease in the frequency and occurrence of headaches. Question 8 If the treatment plan does not work, evidence-based non-pharmacologic approaches can be used. They include relaxation techniques (electromyographic biofeedback, acupuncture, massage), cognitive behavioral therapy, herbs, diets (reduction of dietary fat consumption), and taking supplements (riboflavin, magnesium, melatonin, coenzyme Q10). Question 9 This drug falls in the pregnancy risk category C.
This medication should only be used during pregnancy only if the fetus is at risk. If the patient is with child, and the fetus is not at risk, then medication must be halted (Briggs et al. , 2011).
Briggs, G. G., Freeman, R. K., & Yaffe, S. J. (2011). Drugs in pregnancy and lactation: A reference guide to fetal and neonatal risk. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Buchan, P., Keywood, C., Wade, A., & Ward, C. (2002). Clinical pharmacokinetics of frovatriptan. Headache: The Journal of Head and Face Pain, 42(s2), 54-62.
Buchan, P., Wade, A., Ward, C., Oliver, S. D., Stewart, A. J., & Freestone, S. (2002). Frovatriptan: A Review of Drug‐Drug Interactions. Headache: The Journal of Head and Face
Pain, 42(s2), 63-73.
MacGregor, E. A., Brandes, J. L., Silberstein, S., Jeka, S., Czapinski, P., Shaw, B., and Pawsey, S. (2009), Safety and Tolerability of Short-Term Preventive Frovatriptan: A Combined Analysis. Headache: The Journal of Head and Face Pain, 49: 1298–1314. Cochrane Database of Systematic Reviews 2009, Issue 9, Art. No.: CN-00730994. DOI: 10.1111/j.1526-4610.2009.01513.x
Silberstein, S. D., Elkind, A. H., Schreiber, C., & Keywood, C. (2004). A randomized trial of frovatriptan for the intermittent prevention of menstrual migraine. Neurology, 63(2), 261-269.