American Board of Internal Medicine (ABIM) Certification Practice Exam

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What is the recommended duration for treatment with intravenous dihydroergotamine in status migrainosus?

  1. 1 day

  2. 2 to 4 days

  3. 1 to 3 days

  4. 5 days

The correct answer is: 1 to 3 days

The recommended duration for treatment with intravenous dihydroergotamine in status migrainosus is typically 1 to 3 days. This range allows sufficient time for the medication to effectively manage and potentially resolve the prolonged migraine episode while minimizing the risks associated with prolonged administration of ergotamine derivatives. Dihydroergotamine (DHE) is an effective treatment for acute migraine attacks, particularly when they persist and do not respond to standard treatment options. Administration over 1 to 3 days provides a balance between efficacy and safety. Prolonged use, such as beyond 3 days, may increase the risk of side effects, including rebound headaches or other complications associated with excessive vasoconstriction. It's important to carefully monitor the patient and consider their response to the treatment during this timeframe. This tailored approach helps ensure the best possible outcome while minimizing potential adverse effects.