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Migraine Headaches: A Case Study

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General measures include drinking clear liquids and eating small quantities of dry food, such as soda crackers. If individuals lose the ability to eat or drink and become dehydrated due to repetitive vomiting they may develop metabolic alkalosis and hypokalemia. Intravenous fluids such as half normal saline with 20 mEq potassium chloride may be given to maintain hydration. With persistent vomiting, a nasogastric tube may decompress the stomach and improve overall comfort. Medications may control or prevent vomiting, and may decrease nausea. Therapy should be directed to the underlying cause of the nausea and vomiting. Due to the complexity and multiple causes of nausea and vomiting there is not one agent that is effective in all patients. Frequently using combinations of medications from different classes provides better control of symptoms with less toxicity to patients. Medications can be given through different routes including …show more content…

Serotonin 5-HT3 receptors are found are found in both central and peripheral nervous systems with a high concentration in the GI tract. Serotonin antagonists (e.g., ondansetron, granisetron, and dolasetron) are frequently effective for chemotherapy- and radiation-induced vomiting, gastrointestinal dysmmotility, carcinoid syndrome, and vomiting associated with migraine headaches. 2. Dopamine antagonists (e.g., prochlorperazine, promethazine, and chlorpromazine) and phenothiazines block dopaminergic pathways and have sedative properties. High doses of these medications are associated with dystonia, dyskinesia, and depression. 3. Prokinetic agents (e.g., metoclopramide and erythromycin) are usually used in patients with gastroparesis. 4. Antihistamines (e.g., meclizine and diphenhydramine) have weak antiemetic properties and are used primarily for motion sickness and postoperative states. 5. Sedatives (e.g., diazepam and lorazepam) may be helpful in patients with a psychological component and those with anticipatory nausea and

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