Novel Approaches in Migraine Therapy: Diagnosis and Treatment of Acute and Chronic Migraine

Title:

Novel Approaches in Migraine Therapy: Diagnosis and Treatment of Acute and Chronic Migraine

Topic: Neurology
Relevant Terms: Acute Migraine, Chronic Migraine
Primary Audience: Neurologists, Primary Care Nurse Practitioners, Primary Care Physician Assistants, Primary Care Physicians
Launch Date: 02-Nov-12
Credits: AMA PRA Category 1 Credit
Expiration Date: The accreditation for this activity has expired.
Curriculum Name: Novel Approaches to Migraine Therapy

Learning Objectives

After completing this activity, the participant will demonstrate the ability to:

  1. Identify potential barriers to the recognition and diagnosis of migraine
  2. Differentiate between episodic and chronic migraine
  3. Identify candidates for acute and preventive migraine therapy
  4. Discuss the importance of the administration of acute migraine medication
  5. Develop a treatment plan for patients who are eligible for acute and preventive therapy

    Faculty

    Sheena K. Aurora, MD–Course Leader
    Clinical Associate Professor
    Department of Neurology
    Stanford University
    Stanford, California
    David W. Dodick, MD
    Professor of Neurology
    Mayo Clinic
    Phoenix, Arizona
    Susan L. Hutchinson, MD
    Associate Clinical Professor
    Department of Family Medicine
    University of California-Irvine Medical Center
    Director and Founder
    Orange County Migraine & Headache Center
    Irvine, California
    Director, Hoag Headache and Facial Pain Program
    Newport Beach, California
    Novel Approaches in Migraine Therapy: Diagnosis and Treatment of Acute and Chronic Migraine 
    Release date: November 2, 2012
    Expiration date: November 2, 2013
    Estimated time to complete activity: 1 hour
     
    Co-sponsored by Penn State College of Medicine and Curatio CME Institute
     
    Support for this activity has been provided through an educational grant from Allergan and MAP Pharmaceuticals.

    Activity Overview
    Migraine is a medical condition that affects 12% of the general population of the United States and is one of the most disabling disorders worldwide. Women experience migraines three times more frequently than men, and the age group most commonly affected is adults between the ages of 30 and 40 years. Despite the common occurrence of migraine, many with this condition go undiagnosed. Among those who do receive a diagnosis, the treatment they receive is frequently inappropriate and ineffective. This activity uses a linear, case-based format to address common challenges in the diagnosis and management of both episodic and chronic migraine.
     
    Target Audience
    This activity has been designed to meet the educational needs of neurologists, primary care physicians, primary care nurse practitioners, primary care physician assistants, and other health care providers involved in the diagnosis and management of patients with chronic or acute migraine.

    Accreditation Statement
    Penn State College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This activity is co-sponsored by Curatio CME Institute, an ACCME-accredited provider.
     
    Credit Designation
    Penn State College of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
     
    Method of Participation
    There are no fees for participating in this CME activity. To receive credit during the period November 2, 2012 to November 2, 2013, participants must (1) read the learning objectives and disclosure statements, (2) study the educational activity, and (3) complete the posttest and activity evaluation.
     
    To obtain a certificate, participants must receive a score of 70% or better on the posttest. The posttest can be accessed at the end of the activity. Please e-mail any questions to cmeinfo@curatiocme.com.
     
    For questions about CME credit for this activity, contact Penn State at ContinuingEd@hmc.psu.edu or (717) 531-6483. Reference course #G5155-13-S.
     
    Medium
    The Internet was selected as the instructional format to accommodate the learning preferences of a significant portion of the target audience.
     
    Disclosure
    In accordance with the ACCME Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of everyone in a position to control content of an educational activity. A relevant financial relationship is a relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears below:
     
    Sheena K. Aurora, MD, has disclosed the following relevant financial relationships:
     
    Consultant/Speaker
    Allergan, MAP Pharmaceuticals, Merck
    Research
    Eli Lilly & Company
     
     





    Dr. Aurora discusses the unlabeled or investigational use of a commercial product.

     
    David W. Dodick, MD, has disclosed the following relevant financial relationships:
     
    Consultant
    Alder, Allergan, Arteaus, Autonomic Technologies, Boston Scientific, Bristol Myers Squibb, Coherex, Colucid, Eli Lilly & Company, Ferring, GlaxoSmithKline, Impax Laboratories, MAP Pharmaceuticals, Medtronic, Merck, Nautilus, Neuralieve, Neuraxon, Neurocore, Nevro Corporation, Novartis, NuPathe, Pfizer, SmithKline Beecham, Zogenix
    Grant support
    ANS, Medtronic, St. Jude

    Dr. Dodick discusses the unlabeled or investigational use of a commercial product.

     
    Susan L. Hutchinson, MD, has disclosed the following relevant financial relationships:
     
    Consultant    
    Allergan, Forest Laboratories, GlaxoSmithKline, MAP Pharmaceuticals, NuPathe, Zogenix
    Speaker
    Forest Laboratories, GlaxoSmithKline, Zogenix
     






     
    Dr. Hutchinson discusses the unlabeled or investigational use of a commercial product.
     
     
    Curatio CME Institute
    Thomas Finnegan, PhD, Associate Medical Director, Curatio CME Institute, has disclosed no relevant financial relationships.
    Jonathan S. Simmons, ELS, Senior Managing Editor, has disclosed no relevant financial relationships.
     
    Penn State College of Medicine
    Penn State staff involved in the development and review of this activity have disclosed no relevant financial relationships.
     
    Disclaimer
    The information presented at this activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician regarding diagnosis and treatment of a specific patient's medical condition.
     
    Unapproved Product Use
    This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Curatio CME Institute, Penn State College of Medicine, Allergan, and MAP Pharmaceuticals do not recommend the use of any agent outside the labeled indications.
     
    The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Curatio CME Institute, Penn State College of Medicine, Allergan, or MAP Pharmaceuticals. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

    Generic Name
    Trade Name
    Approved Use (if any)
    Unapproved/ Investigational Use
    Amitriptyline
    Elavil
    For the relief of the symptoms of depression
    Acute migraine therapy; chronic migraine therapy
    Atenolol
    Tenormin
    Management of hypertension; the long-term management of angina pectoris; the management of hemodynamically stable patient with definite or suspected myocardial infarction
    Acute migraine therapy
    Divalproex sodium     
    Depakote
    Monotherapy and adjunctive therapy of complex partial seizures and simple and complex absence seizures; adjunctive therapy in patients with multiple seizure types that include absence seizures
    Acute migraine therapy; chronic migraine therapy
    Duloxetine
    Cymbalta
    Major depressive disorder; generalized anxiety disorder; diabetic peripheral neuropathic pain; fibromyalgia; chronic musculoskeletal pain
    Chronic migraine preventive therapy
    Metoprolol
    Lopressor
    Hypertension; long-term treatment of angina pectoris; treatment of hemodynamically stable patient with definite or suspected myocardial infarction
    Acute migraine therapy
    Sodium valproate
    Depakene
    Monotherapy and adjunctive therapy in the treatment of patients with complex partial seizures that occur either in isolation or in association with other types of seizures; use as sole and adjunctive therapy in the treatment of simple and complex absence seizures, and adjunctively in patients with multiple seizure types which include absence seizures.
    Acute migraine therapy
    Timolol
    Blocadren
    Treatment of hypertension; in patients who have survived the acute phase of myocardial infarction, and are clinically stable, to reduce cardiovascular mortality and the risk of reinfarction.
    Acute migraine therapy
    Topirimate
    Topamax
    Initial monotherapy in patients ≥ 2 years of age with partial onset or primary generalized tonic-clonic seizures; adjunctive therapy for adults and pediatric patients (2 to 16 years of age) with partial onset seizures or primary generalized tonic-clonic seizures, and in patients ≥2 years of age with seizures associated with Lennox-Gastaut syndrome; treatment for adults for prophylaxis of migraine headache
    Acute migraine therapy
    Venlafaxine
    Effexor
    Treatment of major depressive disorder; treatment of generalized anxiety disorder as defined in DSM-IV; treatment of social anxiety disorder, also known as social phobia, as defined in DSM-IV (300.23); treatment of panic disorder, with or without agoraphobia, as defined in DSM-IV.
    Acute migraine therapy; prevention of chronic migraine

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