Describe your assigned client’s situation. Why are they presenting to
the clinic? What medications are they currently taking?
Della Ricci is a 39-year-old female who presented to the clinic with
complaints of frequent migraines. These are accompanied by an aura that
are described as bright zigzagging lights on one side of her vision. Which is
then followed by a unilateral headache that is described to be throbbing
along with significant sensitivity to light. Following these episodes, they
disable her to the point that she must stay in a dark room, and even states
walking worsens the pain. Within the last month, she has reported at least
seven episodes. Her past medical history includes the use of an
intrauterine device for contraception. She denies any allergies and
currently only takes a multivitamin. Della maintains a healthy lifestyle, does
not smoke, and uses alcohol only occasionally. Her physical exam and vital
signs are all within normal limits.
Assess the applicable clinical practice guideline (CPG) for your
assigned client. What treatment is recommended by the CPG for
your client’s situation?
Following the clinical practice guidelines, there are several
recommendations for creating a suitable treatment plan for Della. It is
recommended that treatment for migraines include proper nutrition,
exercise, hydration, adequate sleep, stress management, and logging
migraines (Ailani et al., 2021). First line pharmacological therapies for
acute migraine therapy aid to abort the headache phase of migraines
(Pellesi et al., 2024). These include simple analgesics, caffeinated
analgesics, and antiemetics (Pellesi et al., 2024). These should be given as
soon as possible. If simple analgesics do not work, one should be started on
a second line therapy, such as triptans. Additionally, if one cannot tolerate
triptans, they could be started on gepants or ditans.
Discuss your personal professional assessment of the client’s
situation provided in the scenario. What pharmacological treatment
is necessary and why?
Given that Della is experiencing migraines that are debilitating to her, she
would benefit from pharmacological treatment. She does not report what
medications she has trialed in the past. I would first recommend her to take
simple analgesics at the onset of symptoms, such as headache. If these do
not work, I would then start with a secondary therapy. Since she does not
have any cardiac risk factors, she would benefit from starting on a triptan.
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