Migraine in ER

Migraine in the ER

Acute migraine in ER
👉 IVF👉Oxygen 5-10 L for 5 minutes👉Metoclopramide 5-10 mg IVOR Prchlorprazine 5-10mg IM / IV đź‘‰Magnesium 1 gm IV👉Benadryl 12.5 to 25 mg IV for ADR👉Ketorolac 30-60 mg IM ( max > 65 yrs 60 mg /d < 5 days Rx)👉Triptan : SQ / Nasal / oralSumatriptan 6 mg SQ May repeat in 1-2 hrs (max 12mg/d)Zolmitriptan 2.5 – 5 mg. May repeat in 2 hrs (max 10 mg/d)OR CGRP inhibitors: Nurtec / Ubrelvy
👉Dexamethazone 10 MG IV to prevent post discharge recurrence.👉Occipital nerve block👉AED : IV VPA Valproic acid / Keppra đź‘‰Acetaminophen +/- Diclofenac 

âś…Medication’s which are possibly effective: Medication’s which are possibly effective: 👉👉👉acetaminophen 1 g IV, đź‘‰Acetyle salicylic acid 0.5 to 1.8 gm IV👉 chlorpromazine 0.1 to 25 mg IVk👉 Dexketoprofen 50 mg IV👉 Diclofenac 75 mg IM👉 Dipyrone 1 g IV



❌ not recommended : IV Decadron, Dihydroergotamine SQ / IV; diphenhydramine IV; Ergotamine sc; hydro more phone, lidocaine, morphine, octreotide, ketamine, lysine, meperidine, nalbuphine, Propofol, promethazine, tramadol, trimethobenzamide,

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