Jesani Jennifer, Simerson Darlie
Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois.
Adv Emerg Nurs J. 2019 Apr/Jun;41(2):150-162. doi: 10.1097/TME.0000000000000229.
Migraine headaches account for approximately 1.2 million emergency department (ED) visits annually. Despite the prevalence of this condition, there is little consensus on the best pharmacotherapeutic interventions to use in the ED setting. Guidelines published by the American Headache Society and the Canadian Headache Society offer some direction to ED providers but are not widely utilized. This article reviews the best evidence behind some of the medications frequently used to treat acute migraines in the ED setting, including dopamine receptor antagonists, serotonin receptor agonists, anti-inflammatory medications, opioids, magnesium, valproate, and propofol. The evaluation of patients presenting to the ED with an acute headache, the diagnostic criteria for migraines, and implications for advanced practice are also discussed.
偏头痛每年约导致120万人次前往急诊科就诊。尽管这种疾病很常见，但对于在急诊科环境中使用的最佳药物治疗干预措施，几乎没有达成共识。美国头痛协会和加拿大头痛协会发布的指南为急诊科医护人员提供了一些指导，但并未得到广泛应用。本文回顾了急诊科中常用于治疗急性偏头痛的一些药物背后的最佳证据，包括多巴胺受体拮抗剂、5-羟色胺受体激动剂、抗炎药物、阿片类药物、镁、丙戊酸盐和丙泊酚。还讨论了急诊科急性头痛患者的评估、偏头痛的诊断标准以及对高级实践的影响。
