By vgreene, 31 December, 2019 Counsel family on lifestyle;2,4 identify/avoid HA triggers (menstrual-related, etc)2 and HA1 exacerbators. CBT benefits sx mgmt, per EHF2
By vgreene, 31 December, 2019 If HA treated successfully, but recurs w/in 24h: Take 2nd dose of acute migraine med1
By vgreene, 31 December, 2019 If complex migraine (eg, w/ hemiplegia or brainstem aura): Consider HA specialist referral, per AAN/AHS1
By vgreene, 31 December, 2019 If nausea: Use non-oral formulations if available;1 provide antiemetic meds for children/adolescents prn, per AAN/AHS,1 EHF2
By vgreene, 31 December, 2019 If not responsive to initial tx or SEs not tolerated: Use a different triptan;1,2 offer non-oral formulations if HA peaks rapidly,1 add ibuprofen1 or naproxen1,2 to triptan1 for adolescents
By vgreene, 31 December, 2019 Offer ibuprofen1 2 for established migraine3 in children offer ibuprofen or triptans for adolescents Adjunctive nausea tx prn Lifestyle mod to darr triggers