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Hanah Kerstine Planteras

BSN-III
Medical-Surgical Nursing

February 3, 2015

WEB ASSIGNMENTS:
1. Using the Internet, find a case study of a patient having generalized seizures. What type
of treatment was effective? Explain your findings.
In the case study that I have read, the patient with Traumatic Brain Injury (TBI)
who arrived in the emergency room, experienced generalized seizures during the
emergent Computed Tomography. Administration of Lorazepam (Ativan) and a phenytoin
(Dilantin) bolus, are the management done to the patient in order to control the patients
seizures and these are also the effective treatments for the case.
The traumatic brain injury caused him to have impending cerebral herniation due
to the changes in the cranial ICP. Cerebral oxygen demands were greatly increasing, thus
one of the nursing considerations included management of the variables that affected
these demands. One of the problems were seizures, which was effectively managed
through the administration of 4 mg of IV lorazepam over 2-5 minutes (may be repeated
every 10-15 minutes as needed to a maximum dose of 8 mg). Lorazepam, a
benzodiazepine, is known to cause respiratory depression and hypotension so the patient
was intubated and his blood pressure tolerated the medication.
During seizures, the role of nurses were mostly on recording the events of the
cycle, as well as keeping the patient safe. After the cycle, patients were usually given
anti-seizure medications such as Lorazepam and Phenytoin to prevent any more
occurrences of seizures. Taking in these two medications is important for the patients
case since it would greatly affect his condition if he had again experienced seizures while
in a crucial state.
2. Research an article regarding a new treatment for migraine headaches. Make a reaction.

ARTICLE:

Prevention: The Future of Migraine Therapy


Stopping a migraine headache before it ever begins is the new focus of
treatments.
By Jeanie Lerche Davis
Taking a shower hurts. Shaving hurts. Even your hair hurts when you're in the throes of a
migraine headache.
Until a few decades ago, people had little more than aspirin to fight the throbbing, debilitating
pain of a migraine headache. Then, in the 1980s, researchers developed strong drugs to halt
migraine pain once it begins. But those drugs have serious side effects. Some people cannot take
them if they are at risk for heart disease or other conditions. Also, if the drugs are not taken
within the first hour of migraine headache pain, they don't help much.
These older drugs are still prescribed. But more recently, the approach to taming this lion has
made a 360-degree turn. Now, prevention is the focus. It involves disabling a migraine headache
before the pain ever begins. One method is to take non-migraine drugs daily to help prevent a
migraine from starting. The drugs affect brain chemicals or blood vessel inflammation that lead
to migraines.
Another is to fine-tune treatment for each patient. The goal is to take fewer drugs, avoid many
side effects, and have better control of the beast. For example, you become aware of your pattern
of getting a migraine headache, learn what triggers it, and take certain drugs during your own
window of vulnerability - that is, the brief window of time you can most benefit from a drug.

Finding Your Migraine's Window of Vulnerability


The FDA is currently reviewing a new migraine drug called Trexima, which combines the
migraine drug Imitrex (sumitriptan) and naproxen sodium (a nonsteroidal anti-inflammatory
drug) contained in Aleve and other over-the-counter medications. The triptan prevents blood
vessels from dilating. This dilating leads to migraine pain; the anti-inflammatory drug prevents
release of an inflammation-triggering enzyme, according to product developers.
Also in the pipeline: A drug that shows promise as both in preventing migraines and in stopping
a migraine once one starts, says George R. Nissan, DO, director of research for the Diamond
Headache Clinic in Chicago. The drug works by inhibiting a protein released during
inflammation, called calcitonin gene-related peptide (CGRP). CGRP is found in high levels in
migraine patients.
"We're looking for migraine drugs that don't have the limitations or side effects of antiseizure or
blood-pressure-lowering drugs," Nissan tells WebMD. "CGRP doesn't cause constriction of

blood vessels, so there would be fewer worries for patients with heart disease, and fewer
limitations on its use. However, it may take years until we see it FDA-approved."
Stephen Silberstein, MD, professor of neurology and director of the Thomas Jefferson University
Headache Center in Philadelphia, has led pioneering studies into this "window of vulnerability"
during a migraine headache.
For certain people, especially women with menstruation-related migraines and others whose
triggers are well-defined and predictable, this pre-emptive approach is indeed the future, he tells
WebMD. "More studies are looking at taking preventive drugs during that brief window. For
patients, it's a matter of getting tuned into your particular pattern."
For those who can't take medications or aren't happy with them, a few supplements also show
promise for preventing migraine headaches. "In my own practice, I recommend these if there are
at least two well-controlled clinical trials showing benefit," says Sarah DeRossett, MD, a
neurologist and migraine specialist in Atlanta. "Magnesium, riboflavin (vitamin B-2), and
coenzyme Q10 all fit those criteria."
Reference:
http://www.webmd.com/migraines-headaches/features/prevention-future-of-migrainetherapy?page=1
REACTION:
We all know that the pain felt by a person having a migraine headache is indescribable. In
fact, just by hearing the testimonies of these individuals suffering from migraine, a normal
person who is listening can really see the whole picture of what its like to have experienced a
migraine attack.
Presently, we are very fortunate enough for the new treatments of migraine that has
developed over time due to the advancements of technology. Looking back to a few decades ago,
individuals suffering from migraine was surely devastated since they only had little more than
aspirin to fight the agonizing pain of a migraine headache. Later in the 1980s, the researchers had
already developed strong drugs to halt the pain once the migraine begins. However, these drugs
have serious side effects according to the article above. Thus, the very recent researches for the
new treatment of migraine is now focusing on the prevention of migraine headaches before it
actually begins.
Researches regarding the treatment of migraines nowadays are now focusing on
prevention. I somehow feel glad that our technologies are advancing because I know for sure that
the advancements of these technologies are one key determinant to the discovery of new
treatments for migraine and other illnesses. Altogether, we should be mindful of our health and
aim for preventing diseases since prevention is better than cure.