KK, a 28-year-old female, presents to the neurology clinic for an initial visit for headaches. The patient is complaining of increased unilateral, headache pain with pulsating quality. Additionally, the patient states she experiences nausea, photophobia, and “shimmer lines” lines along with the pain. KK also reports feeling depressed before and after her migraine attacks. Past Medical History: Peripheral neuropathy Family History: Father suffers from migraines Social History: binge drinking on weekends (5 drinks/night), denies smoking or illicit drug use Profession: Accountant studying for the CPA (certification of public accounting) – Patient reports staring at a computer screen for multiple hours per day Allergies: NKDA Vitals: Temperature: 98.7 F Blood pressure: 137/86 mmHg Heart rate: 70 bpm O2 saturation: 98% Medications: – Ibuprofen 400 mg PO q8h PRP o Reports using “many pills” with headaches 1. What subjective and objective information indicates the presence of migraine headaches? 2. What factors could be contributing to KK’s migraines? 3. What are the goals of therapy for KK? 4. What non-pharm therapies can be useful for KK? 5. What abortive pharmacologic options exist for KK? Provide medication, route, dose and frequency.
