A patient reports frequent headaches to the primary NP. The patient describes the headaches as unilateral and moderate in intensity, accompanied by nausea, vomiting, and photophobia. There is no aura, and the headaches generally last 24 to 48 hours
The NP should: a. prescribe dihydroergotamine (D.H.E. 45).
b. prescribe topiramate (Topamax) as migraine prophylaxis.
c. recognize these as classic migraines and order sumatriptan (Imitrex).
d. suggest treatment with acetaminophen because these are probably tension headaches.
C
This patient has symptoms of classic migraine with repeated episodes. Sumatriptan is a first-line medication. Ergotamines are second-line medications. Topiramate is used as migraine prophylaxis in patients who have increasingly frequent migraine episodes. These symptoms are not characteristic of tension headaches.
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