Dhe Headache Protocol

The mean time to return of attacks was 17 days with a mean reduction in VAS of 1 point and an essentially unchanged headache fre-quency when attacks returned although the time to return of the pretreatment frequency was a mean of. DHE is used in the treatment of medically refractory migraine and cluster headache Admission Check any complicating medicines such as triptans 5.

Migraine Headaches Tusom Pharmwiki

Treatment consisted of either continuous iv.

Dhe headache protocol. DHE must not be given to or continued in patients who develop the following conditions. If in the next hour nausea appears or headache disappears give no further medications until 10 pm. Intravenous dihydroergotamine protocol Generic name.

DHE is a medication in a class of drugs called ergot alkaloids. It also stops the release of natural substances in the brain that contribute to migraine pain. If response to DHE discharge with Migranal nasal spray script or DHE sc script 6.

The dose of DHE mesylate ranged from 01 to 05 mg. DHE by infusion pump or repetitive iv. No difference was found in pain relief outcomes at followup in the DHE protocol complete and DHE protocol incomplete groups.

DHE protocol algorithm 82 Headache relief no common side effects 98 Metoclopramide 10 mg IV q 8 hours PRN nausea followed by DHE 05 mg IV q 8 hours for 2-5 days 99 Return to the Migraine Treatment Algorithm box 48 100 Return to the Migraine Treatment Algorithm box 48 97 Caution. One patient had both migraine with aura and new daily persistent headache. Order DHE-45 and metoclopramide Reglan to the floor stat.

DHE and withdrawal of excessively used analgesics analgesic narcotics ergotamines or benzodiazepines. And order 05 mg DHE 10 mg Reglan q 8 h. If responsive to valproate valproic taper 250 tid for 3 d 250 bid for3 d 250 qd for 3 d then stop.

The dose of DHE is lower than is typically utilized in standard adult protocols. Dihydroergotamine DHE Available dosage form. Modify protocol as needed dependent on successfailureside effects of past medications.

If headaches are frequent 4 per mo or repeat ED visits follow up with neurology at Lakewood NI 216-529-7110 9. An outpatient protocol has been used at the Mayo Clinic for several years utilizing self-administered SQ DHE in the treatment of CDH with medication overuse. If additional medications administered in ED advance along pathway as clinically indicated.

Pack enough clothes for your stay you will need day and night clothes as between infusions you will be free to go out and about within the hospital and the local area. Place heparin-lock needle upon arrival of patient. Discharge with PCP follow-up 8.

1 mg1 mL Indicationprocedure. Followed immediately by 05 mg DHE given over 2 minutes. Triptans and DHE are equivalent to the dopamine antagonists for migraine pain relief Opioids are superior to placebo in efficacy Steroid use can decrease headache recurrence after bydischarge.

This protocol is used as guideline made available by pediatric neurologists board certified in headache medicine but is offlabel per Food and Drug Administration in children and adolescents. Repetitive dosing of DHE to treat refractory migraine was first described by Raskin 29. Eighty-nine 925 patients treated with continuous iv.

The patients received an average of five doses of DHE. Conclusions Based on weighted averages of percentage pain relief for medications studied. Dihydroergotamine DHE infusion is a migraine treatment that works by therapeutically contracting some of the blood vessels that supply the tissues that cover and protect the brain.

Fifty-five patients with continuous headache for at least two months most with medication overuse were treated with between 03mg and 1mg of intravenous DHE every 8 hours for 2 days. Pathway assumes patient has received Ketorolac Metoclopramide and Valproic Acid at this point. It is really important to do this as this will help us work out if DHE is helpful in improving your headaches and migraines.

Of the 38 patients 32 reported headache freedom during treatment with DHE. An attempt to reduce the frequency of symptomatic medication use is made while DHE is administered for 2-4 weeks. Give 10 mg Reglan iv.

Independent of the duration of the refractory migraine 80 of the patients responded to the protocol with only minimal side effect. This effect was seen during the stay. Patients who completed the full 8 or 9 dose IV DHE protocol were more likely to have persistent headache at discharge with a median pain score of 10 IQR 0040 compared to a score of 00 IQR 0010 in the DHE incomplete group P 001.

Patients were treated with an IV DHE inpatient protocol that included 5 days of.

Dihydroergotamine Mesylate Dhe Download Table