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A nurse is providing education to a client with a new prescription for sumatriptan (Imitrex) for migraine headaches. Which of the following statements should the nurse include in the teaching?

A.

"You should take this medication daily to prevent headaches from occurring."

B.

"This medication should be taken at the first sign of a migraine headache."

C.

"This medication can be safely used with St. John's Wort to enhance its effects."

D.

"You may crush or chew the tablet for faster absorption if the headache is severe."

Answer and Explanation

The Correct Answer is B

Sumatriptan is used for the acute treatment of migraine attacks and is most effective when taken at the first sign of symptoms. It is not for daily preventive use and should not be taken with serotonergic supplements like St. John’s Wort. The tablet form should be swallowed whole unless otherwise directed by the manufacturer.

Rationale for correct answer:
2. "This medication should be taken at the first sign of a migraine headache.": Early administration increases its ability to stop the migraine before it becomes severe.

Rationale for incorrect answers:

1. "You should take this medication daily to prevent headaches from occurring.": Daily use is not recommended; it increases the risk of rebound headaches.

3. "This medication can be safely used with St. John's Wort to enhance its effects.": This combination increases the risk of serotonin syndrome, which can be life-threatening.

4. "You may crush or chew the tablet for faster absorption if the headache is severe.": Crushing or chewing may alter absorption and effectiveness; the tablet should be swallowed whole.

Take home points

  • Sumatriptan is for acute migraine relief, not prevention.
  • Take it at the first sign of a migraine for best results.
  • Avoid combining with serotonergic substances like St. John’s Wort.
  • Swallow the tablet whole unless your healthcare provider gives different instructions.


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Related Questions

Correct Answer is ["A","B","C"]

Explanation

Chronic tension-type headaches are often associated with muscle tension, stress, and poor posture. Non-pharmacological interventions aim to reduce muscle tightness and stress, and improve coping strategies. Evidence-based approaches such as acupuncture, relaxation training, and biofeedback have been shown to help reduce headache frequency and severity.

Rationale for correct answers:

  1. Acupuncture: Stimulates specific points in the body to help reduce headache frequency and intensity; may benefit some clients with tension-type headaches.
  2. Relaxation training: Techniques like progressive muscle relaxation and deep breathing reduce stress and muscle tension, helping prevent headache onset.
  3. Biofeedback: Teaches clients to monitor and control muscle tension and other physiological processes to reduce headache occurrence.

Rationale for incorrect answers:
4. Feverfew supplements: Primarily used for migraine prevention; limited evidence supports its use for tension-type headaches.
5. Botox injections: Approved for chronic migraine prevention, not indicated for tension-type headaches.

Take home points

  • Stress management strategies are a cornerstone of tension-type headache treatment.
  • Acupuncture, relaxation training, and biofeedback are safe and effective non-drug interventions.
  • Supplements and Botox are better suited for other headache types, particularly migraines.

Correct Answer is D

Explanation

Metoclopramide (Reglan) is often used in the emergency department for acute migraine attacks, particularly when accompanied by nausea and vomiting. It helps relieve gastrointestinal symptoms and can enhance the absorption of co-administered analgesics. It may also have direct anti-migraine benefits due to dopamine receptor antagonism.

Rationale for correct answer:
4. Metoclopramide (Reglan): Effective for acute migraine management, especially when nausea or vomiting limits oral medication absorption. Often given IV along with other acute migraine treatments such as NSAIDs or triptans.

Rationale for incorrect answers:

  1. Divalproex sodium (Depakote): Used for migraine prophylaxis, not acute attacks.
  2. Topiramate (Topamax): An anticonvulsant used for migraine prevention, not for immediate symptom relief.
  3. Propranolol (Inderal): A beta-blocker for migraine prophylaxis, not acute treatment.

Take home points

  • Acute migraine therapy targets immediate symptom relief and often combines antiemetics with analgesics or triptans.
  • Preventive medications (Depakote, Topamax, propranolol) are not effective for aborting ongoing attacks.
  • IV metoclopramide can be a first-line choice in the ED, especially with significant nausea or vomiting.

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