Management of Migraine at Emergency Department

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Migraine is a chronic neurologic disease characterized by recurrent headache generally unilateral, throbbing, moderate to severe in intensity, made worse by the effort and associated with symptoms such as nausea or sensivity to light and sounds....

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Autores principales: Galleguillo, MG, Birissi, PF, Fuentes, V, Lucero, N, Buonanotte, CF
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019
Materias:
headache
migraine
analgesic
cefalea
migraña
analgesico
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/25818
Aporte de:
Revistas de la UNC de Universidad Nacional de Córdoba
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record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-10
container_title_str Revistas de la UNC
language Español
format Artículo revista
topic headache
migraine
analgesic
cefalea
migraña
analgesico
spellingShingle headache
migraine
analgesic
cefalea
migraña
analgesico
Galleguillo, MG
Birissi, PF
Fuentes, V
Lucero, N
Buonanotte, CF
Management of Migraine at Emergency Department
topic_facet headache
migraine
analgesic
cefalea
migraña
analgesico
author Galleguillo, MG
Birissi, PF
Fuentes, V
Lucero, N
Buonanotte, CF
author_facet Galleguillo, MG
Birissi, PF
Fuentes, V
Lucero, N
Buonanotte, CF
author_sort Galleguillo, MG
title Management of Migraine at Emergency Department
title_short Management of Migraine at Emergency Department
title_full Management of Migraine at Emergency Department
title_fullStr Management of Migraine at Emergency Department
title_full_unstemmed Management of Migraine at Emergency Department
title_sort management of migraine at emergency department
description Migraine is a chronic neurologic disease characterized by recurrent headache generally unilateral, throbbing, moderate to severe in intensity, made worse by the effort and associated with symptoms such as nausea or sensivity to light and sounds. It's the most common primary headache and one of the main disabling diseases in the world, being a usual reason for visiting the emergency department. There are many therapeutic options that motivated to investigate types of commonly used drugs, existence of protocols and treatment efectiveness on acute migraine.  The objective was to compare daily clinical practice with literal evidence regarding the management of acute migraine. It was a descriptive study based on semi-structured survey of 100 physicians from public and private emergency departments in Cordoba city during the period of july 2018 and may 2019. The drugs usually used are: dipyrone (63%), dexamethasone (46%), methoclorpramide (46%), ketorolac (43%), diclofenac (32%), ergotamine (5%), triptans (4%), diazepam (1%), prochlorpromazin (1%). The 92% of physicians claimed that the workplace doesn't have standart protocol. Finally, the pain totally improves in 37% of patients and parcially improve in 63% of patients. CONCLUSION: The results partially agree with update international guides wich suggests the use of metoclorpramide, prochlorpromazine, sumatriptan as B evidence level and dipirone, ketorolac, acetaminophen, aspirin, chlorpromazine, diclofenac, haloperidol an valproico as C evidence level for migaine treatment. There isn't enough evidence about the benefit of dexamethasone although it is widely used in our place. This could be related to poor therapeutic response also demonstrated in the present study. Despite the existent of international guides, they aren't used on daily clinical practices, maybe because prevoius experiencie with certain drugs, concerns about adverse effects or availabillity
publisher Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2019
url https://revistas.unc.edu.ar/index.php/med/article/view/25818
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first_indexed 2022-08-20T01:26:48Z
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spelling I10-R10-article-258182019-11-11T21:18:27Z Management of Migraine at Emergency Department Abordaje de Migraña en el Servicio de Emergencias Galleguillo, MG Birissi, PF Fuentes, V Lucero, N Buonanotte, CF headache migraine analgesic cefalea migraña analgesico Migraine is a chronic neurologic disease characterized by recurrent headache generally unilateral, throbbing, moderate to severe in intensity, made worse by the effort and associated with symptoms such as nausea or sensivity to light and sounds. It's the most common primary headache and one of the main disabling diseases in the world, being a usual reason for visiting the emergency department. There are many therapeutic options that motivated to investigate types of commonly used drugs, existence of protocols and treatment efectiveness on acute migraine.  The objective was to compare daily clinical practice with literal evidence regarding the management of acute migraine. It was a descriptive study based on semi-structured survey of 100 physicians from public and private emergency departments in Cordoba city during the period of july 2018 and may 2019. The drugs usually used are: dipyrone (63%), dexamethasone (46%), methoclorpramide (46%), ketorolac (43%), diclofenac (32%), ergotamine (5%), triptans (4%), diazepam (1%), prochlorpromazin (1%). The 92% of physicians claimed that the workplace doesn't have standart protocol. Finally, the pain totally improves in 37% of patients and parcially improve in 63% of patients. CONCLUSION: The results partially agree with update international guides wich suggests the use of metoclorpramide, prochlorpromazine, sumatriptan as B evidence level and dipirone, ketorolac, acetaminophen, aspirin, chlorpromazine, diclofenac, haloperidol an valproico as C evidence level for migaine treatment. There isn't enough evidence about the benefit of dexamethasone although it is widely used in our place. This could be related to poor therapeutic response also demonstrated in the present study. Despite the existent of international guides, they aren't used on daily clinical practices, maybe because prevoius experiencie with certain drugs, concerns about adverse effects or availabillity La migraña es una enfermedad neurológica crónica con manifestaciones episódicas de cefalea generalmente unilateral, pulsátil, de intensidad moderada a severa que exacerba con la actividad física y está asociada a nauseas o vómitos, fotofobia y sonofobia. Es la cefalea primaria más frecuente y una de las principales causas incapacitantes en el mundo, siendo un motivo de consulta frecuente en servicio de emergencia. Existe una variedad de opciones terapéuticas por lo que se decidió indagar sobre fármacos usados en las crisis migrañosas, existencia de protocolo y eficacia. El objetivo del trabajo fue comparar la práctica clínica diaria con la evidencia literaria respecto al abordaje del paciente con crisis de migraña. Se realizó un estudio descriptivo a partir de una encuesta semiestructurada a 100 profesionales médicos, en servicios de emergencia públicos y privados de Córdoba, durante el periodo de julio de 2018 a mayo del 2019. Los fármacos habitualmente usados son: Dipirona (63%), Dexametasona (46%), Reliveran (46%), Ketorolac (43%), Diclofenac (32%), Ergotamina (5%), Triptanes (4%), Diazepam (1%), Proclorpromazina (1%). El  92% de los profesionales afirmaron que el centro en donde desempeñan sus actividades no presenta un protocolo estandarizado. Respecto a la respuesta del dolor el 37% de pacientes se retira con mejoría total y el 63% con mejoría parcial de los síntomas. Los resultados se condicen parcialmente con las recomendaciones bibliográficas las cuales sugieren el uso de Metoclopramida, Proclorpromazina, Sumatriptan como nivel de evidencia B y Dipirona, Ketorolac, Paracetamol, Aspirina, Clorpromazina, Diclofenac, Haloperidol y Valproato como nivel de evidencia C para el tratamiento de las crisis. A su vez, afirma falta de evidencia sobre el beneficio del uso de Dexametasona, el cual es ampliamente utilizado en nuestro medio. Esto podría estar relacionado a la escasa respuesta terapéutica también demostrada en el presente trabajo. A pesar de existir guías terapéuticas, no se evidenció su uso en la práctica médica diaria, ya sea por familiaridad del médico con la droga, experiencia previa sobre su eficacia, preocupaciones acerca de efectos adversos o disponibilidad en el centro de salud Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019-10-17 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/25818 Revista de la Facultad de Ciencias Médicas de Córdoba.; 2019: Suplemento JIC XX Revista de la Facultad de Ciencias Médicas de Córdoba; 2019: Suplemento JIC XX Revista da Faculdade de Ciências Médicas de Córdoba; 2019: Suplemento JIC XX 1853-0605 0014-6722 spa https://revistas.unc.edu.ar/index.php/med/article/view/25818/27601 Derechos de autor 2019 Universidad Nacional de Córdoba

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