11-20-2006, 06:38 PM
A 38 year old stockbroker presents to the emergency room with complaints of several episodes of headaches for the past few days, which have worsened over the past two hours. He had an inital relief of pain with indomethacin, but the pain has now significantly worsened. The patient attributes the headache to stress and excessive alcohol intake over the past few days. He describes the pain as unilateral, mainly in the orbital region, with watering of the eyes, swelling of the eyelids, and nasal congestion. The patient had infrequent headaches of a similar kind in the past, which were relieved with acetaminophen. He was symptom-free for the past six months. He denies taking any other medications. On examination, vital signs are in the normal range. Detailed physical and neurological examinations are normal. The patient is initially given 100% oxygen via a facemask. What is the next step in the management of this patient to relieve his pain?
A. High doses of acetaminophen
B. Sumatriptan 6 mg subcutaneously stat
C. Lithium
D. Verapamil 80 mg stat and every 8 hours
E. Prednisone 60 mg stat
A. High doses of acetaminophen
B. Sumatriptan 6 mg subcutaneously stat
C. Lithium
D. Verapamil 80 mg stat and every 8 hours
E. Prednisone 60 mg stat