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Acute Treatment of Migraine

- BWH Medicine Chiefs @BrighamChiefs

#Migraine #Treatment #management #neurology #headache #medications
Acute Treatment ... of Migraine - ... #Treatment #management ... #neurology #headache ... #medications
Hypokalemia - Differential Diagnosis Algorithm

Transcellular Shift:
 • Alkalosis
 • ↑ beta-2 adrenergic simulation 
 • Erythropoiesis
Transcellular Shift ... Thyrotoxicosis Medications ... Transcellular shifts ... Diagnosis #Algorithm #nephrology ... #low #potassium
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... minutes) Decrease potassium ... • IV Fluids Shift ... potassium intracellularly ... #nephrology
Acute Treatment of Migraine
Mild Attacks: NSAIDs, Simple Analgesics
Moderate/Severe Attacks: Triptans, Ditans, Gepants, Ergots
Non-pharmacologic Treatment: Neuromodulation, Rest,
Acute Treatment ... of Migraine Mild ... Rest, Hydration, Meditation ... neudrawlogy #Migraine ... #management #neurology
Causes of Hyperkalemia - Differential Diagnosis Algorithm
 • Increased Intake
 • Reduced Excretion (IV potassium with
Excretion (IV potassium ... Transcellular Shift ... #Hyperkalemia #Nephrology
Pharmacotherapy for Migraine Prophylaxis 

Who is indicated for migraine prophylaxis? Patients who experience more than 3
Pharmacotherapy for Migraine ... indicated for migraine ... appropriate acute treatment ... #Prophylaxis #Medications ... Pharmacology #Management #Neurology
Prophylactic Migraine Medications

Established Efficacy: 
 • Metoprolol, Propranolol, Timolol, Divalproex, Valproate, Topiramate, Frovatriptan
Probably Effective: 
 •
Prophylactic Migraine ... Medications ... Cyproheptadine #Migraine ... #prophylaxis #Medications ... pharmacology #EBM #neurology
Emergency management of severe hyperkalemia

#hyperkalemia #management #algorithm #nephrology #Potassium #Treatment
management #algorithm #nephrology ... #Potassium #Treatment
Causes of Hyperkalemia

Hyperkalemia is caused by excess potassium intake, impaired potassium excretion, or transcellular shifts. The
caused by excess potassium ... intake, impaired potassium ... transcellular shifts ... renal function, medication ... adapt to excess potassium
Mechanisms of Drug-Induced Hyperkalemia 
 • Direct renin inhibitor (Aliskiren)
 • Renin release inhibition (NSAIDs, Beta-Blockers)
• Increased EC shift ... #pharmacology #potassium ... #medications #druginduced