Clinical GuidelineGuidelineMedication SafetyPatient Education

AAN and AHS updated guidance for choosing and monitoring adult migraine prevention

Neurology (PubMed)Aug 31, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A joint American Academy of Neurology and American Headache Society guideline updates evidence-based recommendations for starting, selecting, monitoring, and discontinuing preventive migraine medication in adults.

What NurseJet pulled from the source

The guideline is based on a multidisciplinary systematic review of evidence through June 6, 2024. Its scope includes when to start prevention, medication choice, efficacy and adverse-effect assessment, discontinuation, medication overuse, older adults, pregnancy and lactation, and coexisting fibromyalgia, obesity, or hypertension; the PubMed abstract does not provide the individual recommendation statements.

Why this matters for nurses

Migraine prevention is not a one-size-fits-all medication choice. Nurses can improve safety and follow-up by capturing headache burden, medication use, reproductive considerations, comorbidities, adverse effects, and whether the preventive plan is meeting the patient's goals.

Bedside takeaway

Capture headache burden, medication use, adverse effects, comorbidities, and reproductive context before preventive-treatment review.

How This Applies in Practice

Use this when: Preparing an adult with migraine for preventive-medication initiation, follow-up, or reassessment.

On your shift

Reconcile preventive and acute migraine medicines, frequency of use, adherence, and patient-reported adverse effects.
Document headache days, functional burden, response to treatment, medication-overuse concerns, and the patient's priorities.
Surface pregnancy or lactation, older age, hypertension, obesity, fibromyalgia, and other relevant conditions to the prescribing team.

Keep in mind: Use the full guideline for medication-specific decisions and discontinuation criteria. Follow facility policy and provider orders.

Key takeaways

The multidisciplinary panel followed the American Academy of Neurology clinical-guideline process.
Recommendations address when to start and how to choose preventive medication.
The guideline considers comorbidities, older age, pregnancy and lactation, sex-related factors, and medication overuse.
Treatment efficacy, adverse effects, and decisions about discontinuation are part of the recommended decision framework.

Practice implications

Reconcile acute and preventive migraine medicines, document headache frequency and functional burden, ask about overuse and adverse effects, and surface pregnancy, lactation, age, and relevant comorbidities to the prescribing team. Use the full guideline for drug-specific recommendations.

Limitations & cautions

The PubMed abstract describes the guideline's scope but does not reproduce its individual recommendation statements, medication-specific cautions, or strength-of-recommendation ratings. This brief therefore does not identify a preferred drug or supply dosing guidance.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

Open source

Public citations are filtered to exact credible source pages. Homepage-only or invalid links stay in admin review and are not shown here.

Neurology (PubMed)

Neurology (PubMed). Pharmacologic Treatment for Migraine Prevention in Adults Practice Guideline Recommendations: Report of the AAN Guidelines Subcommittee and the American Headache Society.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42673560/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

Related briefs

More updates for this clinical area

Back to Discover

Renal failure (PubMed)Sep 7, 2026Research Article

A single-center retrospective cohort found that approximately one quarter of laboratory-defined acute kidney injury cases on internal medicine wards were not documented, particularly when maximal creatinine was lower.

Med-SurgAI summaryReview source

Research ArticleResearchQuality ImprovementAI summary · original source linked below

Among 161 adult hospitalizations meeting serum-creatinine criteria for acute kidney injury, 39 cases (24.2%) were undocumented. Length of stay and in-hospital mortality did not differ significantly by documentation status.

Key takeaways

In the 149 hospitalizations with a demonstrable creatinine change, 33 cases (22.1%) were undocumented.
Higher maximal creatinine was associated with lower adjusted odds of underdocumentation.
The study did not test whether a detection or documentation intervention improves care or outcomes.

Why this matters on shift

A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

Bedside takeaway

Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

Nursing implications

Trend ordered renal-function results and communicate clinically important changes through the care team according to local escalation and documentation workflows.

Limitations & cautions

Abstract-only summary. This was a retrospective, single-center study of 161 hospitalizations; urine-output criteria and reliable preadmission creatinine values were unavailable, and the reference creatinine method may affect case classification.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Renal failure (PubMed). Underdocumentation of laboratory-defined acute kidney injury in internal medicine wards: a retrospective cohort study.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Pediatric emergency care (PubMed)Sep 7, 2026Research Article

A double-blind randomized trial found no reduction in vomiting or faster oral tolerance with intravenous pantoprazole versus placebo in children with acute gastroenteritis and persistent vomiting after ondansetron.

Peds EmergencyAI summaryReview source

Research ArticleResearchMedication SafetyAI summary · original source linked below

The trial randomized 100 children. Vomiting episodes and oral tolerance at 6 and 12 hours did not differ significantly, while median hospital stay was 2 days with pantoprazole and 1 day with placebo.

Key takeaways

The median participant age was 14 months, and 67% of participants were male.
Oral tolerance at 12 hours was 86% in both groups.
The longer stay associated with pantoprazole requires cautious interpretation because this was a single-center trial.

Why this matters on shift

The trial does not support empiric intravenous proton-pump inhibition for persistent vomiting in pediatric acute gastroenteritis after ondansetron.

Bedside takeaway

Clarify the indication for empiric acid suppression and keep hydration and oral-tolerance assessment central to care.

Nursing implications

Prioritize the ordered hydration and oral-tolerance plan, document ongoing emesis, and clarify the indication before administering empiric acid suppression.

Limitations & cautions

Abstract-only summary. This was a single-center study of 100 children in Tehran, and the abstract does not describe adverse events or explain why hospitalization was longer in the pantoprazole group.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Pediatric emergency care (PubMed). Effect of Intravenous Pantoprazole on Clinical Outcomes in Pediatric Acute Gastroenteritis: A Placebo-Controlled RCT.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

European heart journal (PubMed)Sep 6, 2026Research Article

In the pragmatic TARGET-D randomized trial, vitamin D dosing titrated to a serum target did not significantly reduce the composite of death, recurrent myocardial infarction, heart-failure hospitalization, or stroke after myocardial infarction.

Telemetry Med-SurgAI summaryReview source

Research ArticleResearchMedication SafetyPatient EducationAI summary · original source linked below

Among 630 participants followed for an average of 4.2 years, major cardiovascular events occurred in 15.7% with targeted vitamin D management and 18.4% with usual care (hazard ratio 0.85, 95% CI 0.58 to 1.24; P=0.40).

Key takeaways

At baseline, 87% of participants had a 25-hydroxyvitamin D level of 40 ng/mL or lower.
The primary composite outcome and the individual outcomes of death, heart-failure hospitalization, and stroke were not significantly different.
A lower recurrent-MI rate was a secondary finding and should not override the nonsignificant primary result.

Why this matters on shift

The trial cautions against presenting targeted vitamin D supplementation as a proven strategy for reducing major cardiovascular events after myocardial infarction.

Bedside takeaway

Present vitamin D as prescribed supplementation, not as a replacement for established post-MI secondary prevention.

Nursing implications

Reinforce the prescribed secondary-prevention plan and avoid implying that vitamin D replaces therapies with established post-MI benefit.

Limitations & cautions

Abstract-only summary. The trial included 630 participants, 78.1% were men, the primary confidence interval included benefit and no benefit, and individual secondary outcomes were not the primary endpoint.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

European heart journal (PubMed). Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

One in four laboratory-defined AKI cases went undocumented on medicine wards

IV pantoprazole did not improve vomiting or oral tolerance in pediatric gastroenteritis

Targeted vitamin D did not significantly reduce major cardiovascular events after MI