AAN GUIDELINES Product Bundle brought to you by Guideline Central.
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Table 1. Medications Treatment (Brand) Dose Comments Acute Level A Sumatriptan (Alsuma, Imitrex, Sumavel DosePro) 6 mg subcutaneous Injection site reactions, nausea and vomiting, dizziness, fatigue, paresthesias Oxygen 100% at 6–12 L/min by nasal cannula Unpleasant taste, nasal cavity discomfort, somnolence, dizziness, nausea, throat/neck tightness Zolmitriptan (Zomig ) 5 and 10 mg intranasal Paresthesias, heaviness, asthenia, nausea, dizziness, nonchest tightness Level B Sumatriptan (Imitrex) 20 mg intranasal Bitter taste Zolmitriptan (Zomig ) 5–10 mg oral Paresthesias, heaviness, asthenia, nausea, dizziness, nonchest tightness Level C Cocaine hydrochloride 10% intranasal Nasal congestion. Concerns regarding drug addiction and availability of medication Lidocaine 10% intranasal Nasal congestion, unpleasant lidocaine taste Octreotide (Sandostatin) 100 mcg subcutaneous Injection site reactions, diarrhea, abdominal bloating, nausea, dull background headache, letharg y Preventive Level B Civamide (zucapsaicin) a 100 microL of 0.025% intranasal Nasal burning, lacrimation, pharyngitis, rhinorrhea Suboccipital steroid/ local anesthetic injection Transient injection site pain Level C Melatonin 10 mg daily oral No adverse events Verapamil (Verelan PM Calan Isoptin SR) 360 mg daily oral Constipation, reduced blood pressure, reduced heart rate Lithium (Eskalith) 900 mg daily oral Polyuria Transition Steroids – prednisone 60 mg oral daily for 3 days, then decreased by 10 mg every 3 days for a total of 18 days Dihydroergotamine (Migranal, D.H.E. 45) 1 mg subcutaneous/ intramuscular twice a day for several days Ergotamine tartrate (Ergomar) 1 or 2 mg given once daily or in divided doses Suboccipital steroid injections 12.46 mg betamethasone dipropionate and 5.26 mg betamethasone disodium phosphate mixed with 0.5 mL Xylocaine 2% Transient injection site pain a Not currently available.