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Angelica presents with classic migraine headaches occurring…
Angelica presents with classic migraine headaches occurring 8 times per month despite treating with her sumatriptan (Imitrex, a triptan) maximum dose and ibuprofen. She wonders if she can try something else. She has a history of moderate persistent asthma with periodic exacerbations and allergic rhinitis also. She is not pregnant or breastfeeding and has no history of depression. Her Current Medications include Estrogen-progestin combined oral contraceptive 28 day, one tab by mouth daily Fluticasone (Inhaled corticosteroid) 2 puffs twice daily Flonase (nasal corticosteroid) 1 spray in each nostril daily Albuterol (SABA) 1-2 puffs every 4-6 hours as needed for wheezing or cough Montelukast 10mg daily (leukotriene modifier) Sumatriptan 100mg by mouth at onset of migraine HA, may repeat in 2 hours Ibuprofen 400mg by mouth every 8 hours as needed You decide to begin prophylactic therapy. From the options below, choose the best approach given her current medications and comorbidities.
Angelica presents with classic migraine headaches occurring…
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Angelicа presents with clаssic migrаine headaches оccurring 8 times per mоnth despite treating with her sumatriptan (Imitrex, a triptan) maximum dоse and ibuprofen. She wonders if she can try something else. She has a history of moderate persistent asthma with periodic exacerbations and allergic rhinitis also. She is not pregnant or breastfeeding and has no history of depression. Her Current Medications include Estrogen-progestin combined oral contraceptive 28 day, one tab by mouth daily Fluticasone (Inhaled corticosteroid) 2 puffs twice daily Flonase (nasal corticosteroid) 1 spray in each nostril daily Albuterol (SABA) 1-2 puffs every 4-6 hours as needed for wheezing or cough Montelukast 10mg daily (leukotriene modifier) Sumatriptan 100mg by mouth at onset of migraine HA, may repeat in 2 hours Ibuprofen 400mg by mouth every 8 hours as needed You decide to begin prophylactic therapy. From the options below, choose the best approach given her current medications and comorbidities.