A 46-year-old male presents to the Emergency Department with…
A 46-year-old male presents to the Emergency Department with a severe headache. He has had several of these headaches over the last few days and has tried over-the-counter pain relievers with no relief. His current headache started 15 minutes ago. The pain is located next to and behind his left eye and is “stabbing/excruciating.” His left eye tears up profusely with these headaches. He reports he has been healthy otherwise, with no other significant medical history and no drug allergies. On physical exam, the patient appears slightly agitated and uncomfortable. Left eye conjunctiva is mildly injected, and lacrimation is noted. Right eye is normal. Cranial nerves II-VII are intact, but the patient expresses discomfort when the light is shown in his left eye. Speech, gait, coordination, and reflexes are all normal. The remainder of his exam is normal. Brain MRI is performed and reported as normal. Which of the following medications is the most appropriate prevention for this patient’s type of headache?
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