Management of Headaches

Instructions:

For each scenario, please provide the following:

• Identify the type of headache
• Write your specific prescription(s) for the patient. (This must include the medication name, dose, route, and frequency as well as any special instructions that apply as you would include when writing a prescription).
• Provide a rationale for your treatment plan.
• Describe the patient education you would provide in relation to your treatment plan.
• Support your plan and education for each scenario with a minimum of two scholarly references.

Scenario 1:

              Ms. Jane Carter is a 28-year-old female who presents for evaluation of headaches.  She is slightly pale and appears sensitive to the bright lights in the consultation room on exam.  She reports “I’ve been getting these really bad headaches, and they are making it difficult to complete by work.”

Ms. Carter reports  experiencing headaches intermittent since she was a teenager, but they are more frequent in the last six months.  She is experiencing 4 to 5 headaches a month that are lasting from 24 to 48 hours each.  The headaches are generally on the right side of her head and feel like a severe throbbing sensation which she rates as 8 out of 10 pain.  She occasional has nausea and notices she is too sensitive to light and noise to continue to work.  She states her visions seems odd and she will sometimes see zigzag lines in her vision for about 30 minutes before the headaches begin.  She has tried Tylenol, ibuprofen and Excedrin over the counter without adequate relief.  She is not currently taking any other medications.

Scenario 2:

              Ms. Emily Parker is a 38-year-old female who presents for evaluation of recurring headaches.  Ms. Parker appears alert but mildly fatigues and reports “I’ve been getting dull headaches almost every day which are very annoying.”

Ms. Parker has a history of mild to moderate headaches for the past six months that occur on four to 5 days per week and typically last for three to four hours.  She describes the headaches as bilateral and starting at the back of the head, radiating to the forehead.  The headaches are a dull, pressing headache with a sensation of something tightening around her head that she rates as a 5 out of 10 pain.  She has tried acetaminophen over the counter when they come on, but this doesn’t seem to help.  She does usually feel better if she can