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Compazine for a Migraine??

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by Marie_LPN, RN Marie_LPN, RN (Member)

Marie_LPN, RN specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

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elizabells is a BSN, RN and specializes in NICU.

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I also suffer from migraines. My MD prescribed Depakote nightly to prevent

My father is also taking Depakote for migraine...it's amazing how many drugs get "invented" for one thing and turn out to work for another. He has been a little weird since he started taking it - I think it's interacting with his Zoloft.

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RedSox33RN specializes in Emergency Dept, M/S.

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I take Migranal (which is DHE) nasal spray for mine, which usually works (along with 800mg of ibuprofen). I also have some Phenergan, but sometimes I do end up in the ER. I've also heard the "yeah, suuuuuure you have a migraine" attitude more times than I can count (I've had migraines since I was a toddler), and it truly makes me want to give THAT person my migraine, just so they'd KNOW. I always ask them to try Toradol before anything else (and I make clear that I won't take Phenergan IV - I've gotten phlebitis a gazillion times from it - PAINFUL!), but sometimes docs won't because I've taken so much ibuprofen already, and they go to Demerol.

I've learned not to feel "apologetic" anymore for possibly needing Demerol. It has always worked if I need it, and though I hate the hangover the next day, I'll take the pain relief at that cost. Heck, if someone told me to boil bat wings over a cauldron at midnight to get rid of my migraine, I'd do that also. *I* know I'm not drug-seeking (well, maybe I am, since I'm looking for pain relief!). I just want to say to them, "Gee, if I was drug-seeking, don't you think you'd see me more than once every 8 months or so? After all, this is the only hospital within a 40 minute ride."

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I am just a student nurse but we did a rotation today in the ER. The MD was VERY willing to teach and explain and we started talking about migraines and he says that many people come in and want pain meds not necessarily migraine meds and that they don't like him because he only gives Toradol or Imitrex...and won't give pain meds because sometimes they cause rebound migraines.

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elizabells is a BSN, RN and specializes in NICU.

18,480 Visitors; 2,094 Posts

won't give pain meds because sometimes they cause rebound migraines.

So unfortunately true! There's very little I hate more than taking a Norco at night when my back is acting up and waking up w/a migraine.

The two times my migraines have taken me to the ER, I don't think I have any idea what they were giving me. All I know is it made my scalp tingle. I imagine they probably thought I was seeking, since I was in college and had purple hair, but whatever they gave me worked, and no one was ever mean about it, so yay.

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Wound up in the ER a couple of days ago (not at the hospital i work at) with pain throughout my entire head. I have a history of migraines, but this pain wasn't aggravated by light and sound, no nausea or vomiting either (explained all of this to the doctor and the nurse). However, it was bad enough that i was crying from it (not hysterically), and i have a pretty high tolerance for pain.

Anyway, i received Compazine (I saw the name on the vial) by IV, nothing else except a saline flush. Couldn't recall at the moment what class Compazine was, and just made a reminder to myself to look it up later.

Didn't even phase the pain.

Well, it's an antiemetic, and antipsychotic. I'm reading in my drugbook NOTHING about pain relief, just plenty about 'supression of behavioral response'. I'd said my stomach felt fine, just in a lot of pain. I wasn't asking for any drugs or any drug in particular, but i'm a little curious that after getting the sinking feeling that since i was new to that ER, since pain cannot be seen, plus the demeanor of the staff, and a remark i overheard the nurse make ("we got ANOTHER headache out there, is there some sort of special we're advertising that no one told me about?"), that i was perceived as a drug seeker, and now i'm wondering if i was given this medication just to be pastied and get discharged.

I'm looking around as i write this, and not finding anymore than what i found in the drug book. Any ideas?

The ER I work uses Ativan 1mg, Benadryl 25mg, and Compazine 10mg IV for migraines. Narcotics are rarely given. This seems to work very well.

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akcarmean specializes in Home Health Care,LTC.

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I have suffered from migraine for a long time since I was about 13. I take Inderall 120 mg d, Neurontin 300 mg 2/am and 2/pm,

These are the ones I have at home to help stop the migraine once it has begun. I have Torodol 10mg @ home along with Imitrex, I also have 800 mg, Ibuprofen. I have been fighting a migraine for 2 weeks now.

I also take right now 50mg Ultram TID for my chronic/severe back pain. I am trying to hold off going to the ER b/c of all the meds. I have already tried. But I am ready to break down. I have been to my ER for so many years and several times for migraines that I usually when I go have to end up having demerol and phenergan and then go home and sleep for two days before I can get rid of it.

I always try to exhaust all of my measures at home first before going to ER; but when the meds at home don't work combines with cool compresses and sleep. It's time for the visit to the ER. At least I don't get any problems when I state that I want demerol and something for the nausea. All the nurses and pretty much all the doctors know me all ready to know what works and I take so many different medications for so many different things that I have a typed list of my dx, allergies to meds, medication how much and how often so all they have to do is go photocopy it and ask what I have already tried.

I never used to be specific with what medication I wanted but after becoming a nurse and years of experience with what works and what is just a waste of my time I have become a little more outspoken.

If there is a new doctor in ER then sometimes I end up back in there b/c the meds. they gave me what what I had already been taking at home and hasn't worked.

So sorry you had that experience, I know it always makes me upset to be treated that way. I would love to some one who hasn't had a migraine to have one just once and then they would never, ever say another commit like that again.

Take care and hope you are feeling better.

Angie

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webbiedebbie has 22 years experience and specializes in OB, Telephone Triage, Chart Review/Code.

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I used to suffer for many years from what the docs would call "migraines". Years later, I was flat on my back for 4 weeks. Everytime I would lie on my back, I had no pain. As soon as I turned in my sleep to my side, I would wake up with a "migraine". Ended up in the ER...brain scans were all negative. Home with prescription for narcotics.

One day I thought I was having a stroke...my speech was slurred and my right pupil was dilated. My MD was not on call, so another had me come into the office after hours and ordered an MRI of my cervical spine. I had Arnold Chiari Malformation! Finally, an answer! Waited one year before having the surgery.

Truly I can say, I have only had about 3 real migraines in the 5 years since I had the surgery...and these migraines are no where near the pain I had before.

Migraine sufferers...ask your doc to check your neck. I wish someone would have checked mine sooner!

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New here, but this is a topic very interesting to me :)

I recently graduated with my 2nd degree as a BSN...soon to be RN (with fingers crossed!) My first degree was in music.

During my sophomore year of my first degree, I got a 'headache' which has never left. For all intents and purposes, it is referred to basically as Chronic Daily Migraine, but it has a longer and more confusing diagnostic name...

In the fall of 2003, I was also diagnosed with having Cluster Headaches...which turned chronic after a year of suffering with no relief.

This past March, while doing an ER rotation, I actually wound up in the ER (on the first day of clinical no less...) with what they then diagnosed as a basilar migraine. Lamictal has taken care of the basilar migraine, thank goodness!

It's trial by fire, to say the least. I have been in the hospital for these conditions alone about 8 times. I recently had surgery on both knees because I got Avascular Necrosis from taking steroids for the headaches. I've had the joyous experience of having DVTs, severe med reactions, and on down the line, but I try not to think about it much!

I actually went into nursing (health care, in general as nursing wasn't always my plan) because I wanted to work in headache neurology. After much soul searching, I decided that it was "too close" to what I live on a daily basis...24/7 for about 4.5 years now. I start my career as a neonatal nurse in a week! I couldn't be happier about that decision, and I know I've made the right choice.

But while in nursing school (went to a 1 year program), I had the opportunity to do an honors project. Mine was entitled, "More Than Just a Headache: Improving the quality of migraine and headache education for future nurses." I hope to publish it, now that I have a slight bit more time than I did in school! Basically I was rather saddened by a lack of solid education in this area for nursing students, which was resulting in a major lack of knowledge for nurses working in the field. My project included about 6 power point presentations... To make a long story short, they touch on topics of Pathophysiology, Nursing Management, and Pharmacology of migraine and headaches.

This week, I'll be attending the annual meeting of the American Headache Society, and I'm very excited to learn anything new that has come out. I hope also to maybe get an idea for what I can do to get my own piece of mega-work published! I used to work for a headache center in research (very briefly), and it really taught me quite a lot!

At any rate - in our ER (I also used to work in the ED...but not as a nurse), they typically give toradol, DHE, zofran/reglan/compazine (take your pick!), potentially steroids (depending on a few factors...), IV fluids, and others I've received were a knockout one time dose of valproic acid and another time received droperidol. The list of potential meds is longer than most 'normal' people can generally fathom! However, fortunately treatment is ever-changing. :)

Even though I'm going into neonatal nursing, migraine and headache education for nurses, patients, physicians, and basically everyone is still something that I will always work on and hold very close to my heart! All of the suffering I've lived through personally with these conditions the past 4 1/2 years or so have to be worth it for something!! I've already had the joy of knowing that I have helped others in various ways (often small, but significant to them and to me!), and even if I only ever helped one other person by going through what I've been through, then it would all be worth it!

Guess I should go to the Introductions page and do that...now that I wrote all this!!

Carrie :)

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rach_nc_03 specializes in PICU, Nurse Educator, Clinical Research.

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I didn't want to go to the ER (if i say "ED", i think of Bob Dole and Viagra commercials, yuck), but i also didn't have any medicine for a migraine, except for Excedrin Migraine, which had worked well untill the other night, when i took it, and an hour later it had gotten worse. That was the worst pain i'd ever had (though i've never experienced labor, though), and i worried it was something else.

Sad to say, i was afraid of being seen AS a drug seeker, coming in, complaining of pain, knowing that someone is going by what you tell them it is, and also knowing that what's excruciating to one person is a tingle to someone else.

I've decided to persue this (treatment) further with my regular doc, just to try and avoid having to hope someone believe you when you're hurting.

marie,

so sorry to hear about the headache AND the crappy remark! did you follow up with a neurologist? working in neuro last year, i worry when i hear about headaches like this. take care of yourself, and let us know if you get a definitive dx.

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rach_nc_03 specializes in PICU, Nurse Educator, Clinical Research.

3,992 Visitors; 372 Posts

New here, but this is a topic very interesting to me :)

I recently graduated with my 2nd degree as a BSN...soon to be RN (with fingers crossed!) My first degree was in music.

During my sophomore year of my first degree, I got a 'headache' which has never left. For all intents and purposes, it is referred to basically as Chronic Daily Migraine, but it has a longer and more confusing diagnostic name...

In the fall of 2003, I was also diagnosed with having Cluster Headaches...which turned chronic after a year of suffering with no relief.

This past March, while doing an ER rotation, I actually wound up in the ER (on the first day of clinical no less...) with what they then diagnosed as a basilar migraine. Lamictal has taken care of the basilar migraine, thank goodness!

It's trial by fire, to say the least. I have been in the hospital for these conditions alone about 8 times. I recently had surgery on both knees because I got Avascular Necrosis from taking steroids for the headaches. I've had the joyous experience of having DVTs, severe med reactions, and on down the line, but I try not to think about it much!

I actually went into nursing (health care, in general as nursing wasn't always my plan) because I wanted to work in headache neurology. After much soul searching, I decided that it was "too close" to what I live on a daily basis...24/7 for about 4.5 years now. I start my career as a neonatal nurse in a week! I couldn't be happier about that decision, and I know I've made the right choice.

But while in nursing school (went to a 1 year program), I had the opportunity to do an honors project. Mine was entitled, "More Than Just a Headache: Improving the quality of migraine and headache education for future nurses." I hope to publish it, now that I have a slight bit more time than I did in school! Basically I was rather saddened by a lack of solid education in this area for nursing students, which was resulting in a major lack of knowledge for nurses working in the field. My project included about 6 power point presentations... To make a long story short, they touch on topics of Pathophysiology, Nursing Management, and Pharmacology of migraine and headaches.

This week, I'll be attending the annual meeting of the American Headache Society, and I'm very excited to learn anything new that has come out. I hope also to maybe get an idea for what I can do to get my own piece of mega-work published! I used to work for a headache center in research (very briefly), and it really taught me quite a lot!

At any rate - in our ER (I also used to work in the ED...but not as a nurse), they typically give toradol, DHE, zofran/reglan/compazine (take your pick!), potentially steroids (depending on a few factors...), IV fluids, and others I've received were a knockout one time dose of valproic acid and another time received droperidol. The list of potential meds is longer than most 'normal' people can generally fathom! However, fortunately treatment is ever-changing. :)

Even though I'm going into neonatal nursing, migraine and headache education for nurses, patients, physicians, and basically everyone is still something that I will always work on and hold very close to my heart! All of the suffering I've lived through personally with these conditions the past 4 1/2 years or so have to be worth it for something!! I've already had the joy of knowing that I have helped others in various ways (often small, but significant to them and to me!), and even if I only ever helped one other person by going through what I've been through, then it would all be worth it!

Guess I should go to the Introductions page and do that...now that I wrote all this!!

Carrie :)

you rock! let us know if/when you publish...this is near and dear to me as well, as i have a dx of chronic daily migraines. currently taking 200 mg of lamictal daily, demerol/phenergan prn (which is around 4x/week), and dexamethasone for the times when i can't get out of bed for days on end. i take 10 mg/day of methadone for severe pain from endometriosis with abdominal adhesions (trying to taper off since surgery this march), but the methadone does nothing for my headaches. i live alone and worry that someday i'll have another one that blinds me, and no one will know.

i was shocked in nursing school to hear the attitudes expressed by some instructors...from saying that most migraineurs are addicted drug-seekers to preaching 'guided imagery' as better than meds. only one instructor- a chronic pain pt. herself- told us to listen to these patients when they tell you what meds they need. usually, we know what works!

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Hi, I get Migraines. I cannot predict but they are really bad. I just graduated from RN school, and I was a nutritionists for 15 yr also, for 1 year, worked in a ER of a major medical center. I walked into a room to see if the pt. (girl) needed health insurance...that was my job there. She was crying and in so much pain from a migraine. It did not look like an act to me. She begged me to go get a nurse. I did and the nurse said "we know, she always comes in with that kind of pain" wlaked away and ignored my plea (and the patients) and made her wait. All I can say is I wouldn't wish my migraines on anyone but people like that, and the little nurse with the comment in the hallway about you. And what the heck are those people doing in the medical field. They need to be working with lab. rats or something.

You need to officially complain for all that it is worth. I notice something else....if you complain within a facility...the complaint stays there...if you complain outside of the facility....you will see immedicate results. Why not send a copy of your letter to the health department or JACHO. It cannot hurt, it may help another victim. Let that nurse have it, she has nerve.

Last week I was coming back from a car trip, 8 hrs. away. I got a migraine, I was so worried that I would not be able to drive. I could only take so much of anything while I was driving. I pulled off the Thruway to a rest stop. I had one imitrex. I went in got a coffee, took the imitrex. Took the ice bags out of the cooler and put them on my neck and the base of my head where it felt like it was going to explode and thankfully it subsided. I don't know what I would have done in the middle of nowhere by myself.

I lost my medical insurance when I left my husband because he refused to let me go to nursing school....so that imitrex was my last hope, my last pill. An ER visit would have cost me, I did not get a job yet. Just adds to the migraine!

They are real, there is not an explaination but no one should look at them as a drug seeking behavior.

Walk a mile in my shoes....my favorite saying.

Wound up in the ER a couple of days ago (not at the hospital i work at) with pain throughout my entire head. I have a history of migraines, but this pain wasn't aggravated by light and sound, no nausea or vomiting either (explained all of this to the doctor and the nurse). However, it was bad enough that i was crying from it (not hysterically), and i have a pretty high tolerance for pain.

Anyway, i received Compazine (I saw the name on the vial) by IV, nothing else except a saline flush. Couldn't recall at the moment what class Compazine was, and just made a reminder to myself to look it up later.

Didn't even phase the pain.

Well, it's an antiemetic, and antipsychotic. I'm reading in my drugbook NOTHING about pain relief, just plenty about 'supression of behavioral response'. I'd said my stomach felt fine, just in a lot of pain. I wasn't asking for any drugs or any drug in particular, but i'm a little curious that after getting the sinking feeling that since i was new to that ER, since pain cannot be seen, plus the demeanor of the staff, and a remark i overheard the nurse make ("we got ANOTHER headache out there, is there some sort of special we're advertising that no one told me about?"), that i was perceived as a drug seeker, and now i'm wondering if i was given this medication just to be pastied and get discharged.

I'm looking around as i write this, and not finding anymore than what i found in the drug book. Any ideas?

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899 Visitors; 25 Posts

Hi, I get Migraines. I cannot predict but they are really bad. I just graduated from RN school, and I was a nutritionists for 15 yr also, for 1 year, worked in a ER of a major medical center. I walked into a room to see if the pt. (girl) needed health insurance...that was my job there. She was crying and in so much pain from a migraine. It did not look like an act to me. She begged me to go get a nurse. I did and the nurse said "we know, she always comes in with that kind of pain" wlaked away and ignored my plea (and the patients) and made her wait. All I can say is I wouldn't wish my migraines on anyone but people like that, and the little nurse with the comment in the hallway about you. And what the heck are those people doing in the medical field. They need to be working with lab. rats or something.

You need to officially complain for all that it is worth. I notice something else....if you complain within a facility...the complaint stays there...if you complain outside of the facility....you will see immedicate results. Why not send a copy of your letter to the health department or JACHO. It cannot hurt, it may help another victim. Let that nurse have it, she has nerve.

Last week I was coming back from a car trip, 8 hrs. away. I got a migraine, I was so worried that I would not be able to drive. I could only take so much of anything while I was driving. I pulled off the Thruway to a rest stop. I had one imitrex. I went in got a coffee, took the imitrex. Took the ice bags out of the cooler and put them on my neck and the base of my head where it felt like it was going to explode and thankfully it subsided. I don't know what I would have done in the middle of nowhere by myself.

I lost my medical insurance when I left my husband because he refused to let me go to nursing school....so that imitrex was my last hope, my last pill. An ER visit would have cost me, I did not get a job yet. Just adds to the migraine!

They are real, there is not an explaination but no one should look at them as a drug seeking behavior.

Walk a mile in my shoes....my favorite saying.

Nice words...I can also add a few choice 'quotes' to the list...

In the ER, I overheard a nurse tell a neurology resident-friend of mine that she "wished all these migraine patients would just go home and go to bed."

One night, a pool nurse on the tele unit and I were talking about her experiences in the pool. I told her that I wanted to work in headache neurology. She said to me, "Oh I could never do that. I have absolutely NO sympathy for those people." Those people???!!! Sympathy?? :angryfire

I told her that I'd been admitted at that hospital 6 times alone for migraine and headaches. She just walked away.

I've heard such a variety of comments - in the hospital working and also as a patient - it breaks me up. But now, instead of sitting silently, I use it as a prime opportunity to 'educate' -- and if education doesn't work, then at least it generally shuts them up - at least around me! I can't stand people who make comments like that. Obviously NOT working in a caring profession because they care...

carrie :)

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