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Migraine is a neurobiological headache disorder that affects around 16% of adults in the United States. Medical treatment of mild to moderate migraines include non-prescription non-steroidal anti-inflammatory drugs, acetaminophen, or aspirin and caffeine-containing combination analgesics. Additionally, moderate to severe migraines and those that are mild to moderate that have not responded to analgesics can be treated with triptans, which are drugs specific for migraine treatment. Non-pharmacological treatments include cognitive behavioral therapy and relaxation training. Medications for the prevention of migraines have also been developed since they are more affective in offsetting the symptoms. Ubrogepant’s high specificity and selectivity for calcitonin gene-related peptide (CGRP) sets it apart from certain other drugs, which previously limited the treatment of migraines with or without aura due to their decreased selectivity. The most frequently reported side effects are oropharyngeal pain, nasopharyngitis, and headache. Most studies found that participants receiving Ubrogepant were free from pain within 2 h when compared to placebo. Patients taking Ubrogepant should avoid taking it when pregnant or with end stage renal disease. In summary, Ubrogepant has good tolerability and an overall favorable safety profile. It appears to hold promise for the acute treatment of migraines with or without aura in adults.

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Introduction Central venous catheters are essential and widely used in medical practice. Their use may be accompanied with complications during insertion and removal. Complications related to the guidewire are rare, and information about appropriate management is scarce. We report a case of a 34-year-old patient admitted for a left femur fracture. The patient was a difficult access, so decision was made to place a central venous catheter before surgery. During insertion of the central venous catheter, there was difficulty in advancing the guidewire. Attempts were made to remove the guidewire through the introducer, but the guidewire would not thread out of the introducer. The introducer and guidewire were then removed as a unit with ease. The guidewire had lost its shape and uncoiled itself, becoming much more flimsy and fragile. Conclusion While this case had no adverse outcome secondary to the removal of the guidewire and introducer as a unit, careful attention should be noted when attempting to remove the guidewire during central venous catheter placement. If faced with a similar scenario where the guidewire is stuck and does not thread out easily, removing the guidewire and introducer as a unit is a safe method of action.