Down the Line

Here was the order of medications to which I gave a patient with chronic migraines. See if you can guess which one finally worked?

1. Reglan

2. Imitrex

3. Decadron

4. Toradol

5. Depakote

6. Dilaudid

Ding, ding, ding!  If you guessed #6 you get a gold star!  Not that this was a hard question….

6 Comments

  1. Comment by webhill:

    Well, you know…. fact is, the few times I’ve ended up in the ER with a migraine (and in the past 30 years that I’ve had them, I can think of only 6 times I’ve had to go to the ER because of it) the only thing that worked for me was meperidine & phenergan. So.

  2. Comment by c8h10n4o2:

    Took my second Imitrex 4 hours ago and I’m about to take my 3rd phenergan of the day, and damned if I don’t wish that I still had some mepergan fortis from previous surgeries handy. The very idea of moving and dealing with my mother for a ride just makes the pain worse, unfortunately. I’d even take the phenobarb that I used to get in the ’90s. It still hurt, but I sure didn’t care.

  3. Comment by Amy:

    Man, I would give away my bottly of oxycodone for a shot of toradol on most days. (Says the girl with RA and Loin Pain Hematuria Syndrome whose nephrologist and rheumatologist both agreed she cannot have any NSAIDS…..)

    although, I gotta tell ya, dilaudid will pretty much keep you from feeling your body, let alone any pain. I could see where that would work. (yeah, I know, I know…….that patient was a person who needed to treat hangnails with “that D medicine”)

  4. Comment by Mary:

    I know I wouldn’t have been given Imitrex (which has no effect upon me) because by the time I showed up at the hospital I would have take 2X to 3X the recommended dose of my triptan. And, the doctors and nurses would ask what it was.

    If you gave me 4, 5 and 6 I really hope you added back an anti-emetic. Just reading the list is making me nauseated. I don’t need the d-drug. I need you to give me whatever the hell it takes to make me stop puking and knock me out for about 12 hours. I know you can’t fix the pain.

  5. Comment by Meghan:

    We love us some Droperidol+Benadryl+Toradol+IVF ’round these parts. It actually does seem to work on most pts. Even if it is the droperidol and benadryl just knocking them out. (I know a lot of places are anti- droperidol these days, but we give a nice lil 0.625mg dose)

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