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Migraine with Aura in pregnant patient who is on Oral Contraceptives -…
Migraine with Aura in pregnant patient who is on Oral Contraceptives
Acupuncture, Cognitive Behavioral Therapy, Meditation, Yoga
Herbs, Vitamins & Minerals, Massage, Exercise, Talk Therapy
PHARMACOLOGIC MANAGEMENT
Document AURA, photophobia, triggers
PARACETAMOL 1000mg as a suppository is the 1st Rx of choice
Migraine, TASK 3, Group 6, Dr. Sarah Shahab, 12/03/23'
ASPIRIN in 1st & 2nd Trimesters. Risks are prolonged labour, PPH, Neonatal bleeding, Premature closure of Fetal ductus arteriosus...Risk of Reyes syndrome with impaired platelet function
CODEINE can be used in combination
IBUPROFEN unto 600mg daily. NSAIDS after 30 weeks can cause premature closure of Ductus Arteriosus & oligohydramnios
ANTI-EMETICS eg. Prochlolperazine, Cyclizine, Chlorpromazine & Buclizine used in pregnancy & lactation
Domperidone & Metoclopramide can be used in pregnancy in fact increase prolactin & milk volume
INJECTIBLES; Eptinezumab, erenumab, firemanezumab, galcanezumab
PHYSICAL THERAPY
RELAXATION THERAPY, ICE PACKS, BIO FEEDBACK
Sleep pattern, Healthy diet, fluid intake for good hydration
Identify stressors that cause Migraine
Remove foods like cheese, caffeine, alcohol, smoking if they trigger migraine
Avoid bright light, sounds
NON-PHARMACOLOGIC RX
CGRP..calcitinin gene-related peptide
PROPRANOLOL can be used for prophylaxis of migraine
Drug overuse like aspirin, acetaminophen, NSAIDS, sedatives, codeine & prescription narcotics can cause migraine
Sumatriptan, zolmatriptan, ergotamine can be used in pregnancy
2nd line options: Prentral NSAID ketorolac, INTRANASAL dihydroergotamine
References: Curr Opin Neurol 2015 Jun; 10(3):237-43-Pubmed
OCs cause migraine due to estrogen