Pharmacology And Migraine Research

Evidence based practice is the basis for needed change in practice and function. It is a sound method for scientific, fact-based change. Changes which have no evidence to support them are fragile, unscientific, and subjective. These changes don’t effect real change over time, as they aren’t able to be proven to a more general population.

Despite my periods of light remission from pregnancy, every day I wake and go to sleep with a migraine. It escalates and deescalates during the day depending on countless factors. Children are wonderful, needy little people that require attention at all times of day and night. Pain doesn’t care that my kids need breakfast and want to be played with.

Evidence-based practice is a systematic approach to rational decision making that facilitates achievement of best practices and can be used as a guide to help nurses make effective, timely, and appropriate clinical decisions in response to the broad political, professional, and societal forces that nurses and other health professionals are confronted with daily (Scott and McSherry, 2009).

Evidence based practice is a practice that is based upon the best available evidence, patient preferences, and clinical judgments (Schmidt & Brown, 2012). According to Schmidt and Brown the nurse’s standpoint of patient care obliges nurses to form their own body of evidence through scientific research (Schmidt & Brown, 2012). A nurse encounters many patients with various disease processes throughout their careers. Overtime the nurse will be able to see which treatments work and which ones need improvements or can even do without. Nurses are key players when it comes to evidence based practice.

suffer from Migraines usually experience pain on one side of their head. There are several

Migraines affect nearly 28 million people or 12% of the population in the United States. Migraines are typified by moderate to severe head pain. The head pain is often accompanied by one or more of the following; nausea, photophobia, phonophobia or vomiting. Migraines are considered a chronic neurological disorder. The incidence of migraine related nausea (MRN) is very high among migraneurs. Roughly 90% of patients experience MRN at one time or another. Roughly 50% of patients report experiencing MRN with high frequency (greater than half the time). MRN can hinder the efficacy of currently available migraine drugs in a number of ways. Many patients who experience MRN will delay or avoid taking oral or nasal migraine medication as it can further irritate their stomach. The GI upset associated with migraines can also affect absorption and thus limit systemic exposure to the drug. Researchers have been working diligently to find a solution to this problem.

According to the World Health Organization (WHO), migraine is recognized and its impact categorized as causing the same level of disability as dementia, quadriplegia and acute psychosis. Additionally, the WHO characterized chronic migraine as equal to or more disabling than blindness, rheumatoid arthritis or paraplegia angina. (19)

Migraines are different than headaches. While headaches do have pressure and pain associated with them, migraines are more intense and usually have other symptoms that

“Evidence based practice is a process involving the examination and application of research findings or other reliable evidence that has been integrated with scientific theories” and taking into consideration the patient’s preferences and values (Schmidt & Brown, 2015, p.4). It is constructed from the three components of patient preferences, clinical judgment or expertise, and the best available evidence (Schmidt & Brown, 2015). Evidence based practice is an important tool to provide the highest quality of patient care, improve patient outcomes, and reduce patient care costs (Schmidt & Brown, 2015).

Chronic migraine is a debilitating condition with over $1 billion in medical cost and $16 billion in lost productivity per year in the United States. (25) Here we examine the efficacy of onabotulinumtoxinA [botox] injections versus topiramate as prophylactic therapy for chronic migraine (CM) in adults. Chronic migraine (CM) is a specific and relatively newly defined sub-type of Chronic Daily Headache (CDH) defined as “more than fifteen headache days per month over a three month period of which more than eight are migrainous, in the absence of medication over use. Episodic migraine is the other migraine sub-type, which is defined as less than 15 headache days per month.” (14)

Evidence-based practice applies what knowledge was discovered from the research into clinical practice. While evidence-based practice is honed in on clinical questions appropriate for clinical settings and patient care; research questions can be done in any field or any practice. These types of questions also affect how information is generated, what kind of questions can be posed, testing, analysis, and evaluation. From the evidence-based practice standing information should come from an application of knowledge from a point of care, literature that is evidenced-based, a clinical point of view, subjects that are patients, patient data analysis, and evaluations are measured by the outcomes of patients.

Migraine is an episodic syndrome consisting of a variety of clinical features that result from dysfunction of the sympathetic nervous system. During headache-free periods, migraineurs have a reduction in sympathetic function compared to nonmigraineurs. Sympathetic nervous system dysfunction is also the major feature of rare neurological disorders such as pure autonomic failure and multiple system atrophy. There are no known reports in the medical literature, however, comparing sympathetic nervous system function in individuals with migraine, pure autonomic failure, and multiple system

Kurth et al. evaluated the association of migraine and cardiovascular events in women and reported that women with active MA have approximately a twofold risk for both ischemic stroke and myocardial infarction (Kurth et al., 2008). The authors also analyzed the impact of the overall cardiovascular risk pro- file using the Framingham risk score. Interestingly in those women whose risk score was lowest the association of MA and ischemic stroke was highest (OR 3.88), whereas in those women whose risk score was highest the association of MA and myocardial infarction was highest (OR 3.34). Previously it has been reported that MA is associated with elevated risk of myocardial infarction (OR 2.1) in women and that MA is responsible for up to 18 major

A migraine is a common, chronic, and debilitating neurovascular disorder. It is characterized by attacks of serve headache along with autonomic nervous system dysfunction and some patients an aura neurological symptom (Goadsby, Lipton, & Ferrari, 2002). There are two types of migraines classical migraine and common migraine. Classical migraine is one that either preceded or accompanied by focal neurological symptoms which are generally visual, this occurs in 15% of patients and is referred to migraine with aura (Goadsby, Lipton, & Ferrari, 2002). Common Migraine is one that has episodes of head pain that are severe and throbbing and can last 4 to 72 hours. These are migraines without aura and are usually associated with nausea, vomiting and sensitivity to light, sound or movement (Sorge et al., 1988). When diagnosed with frequent migraine attacks, doctors try to understand what the cause of a subject’s migraines are which can be due to many variables such as stress, sleep deprivation or menstruation.

Additionally, there is no specific cure for migraine headaches. In addition, the goal in treating migraines is to treat migraines symptoms. Also, migraines can be treated with amitriptyline or venlafaxine. Furthermore, a migraine can be treated with blood pressure medicines such as propanolol. Researchers have also proven that migraines can be treated with seizure medicines such as valproic acid. (http://www.sciencedaily.com/news). In addition, when I read that you can treat a migraine with seizure medications, I thought that research finding was interesting to be aware of. Also, researchers stated that you could treat a