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OTC > Exam 3 - Headaches, Drowsiness, and Fatigue > Flashcards

Exam 3 - Headaches, Drowsiness, and Fatigue Flashcards

1
Q

Are migraines or tension headaches more common

A

Tension headaches

Migraine: 1.04 billion
Tension: 1.89 billion

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1
Q

Headache epidemiology

A
  • headache disorders are the most common disorder of the nervous system
  • associated with pain, disability, and decreased quality of life
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2
Q

What demographics are headaches more common in

A

Women and younger populations

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3
Q

Headache statistics (prevalence)

A
  • 50% of the world’s adult population has experience HA within the past year
  • 5th most common reason for ED visit and accounts for ~3% of all ED visits
  • 1 in 6 Americans report severe HA within past 3 months
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4
Q

Health disparities include issues involved in:

A

Incidence
Prevalence
Migraine-related pain disability
Access to care
Quality of care

(IMPAQ)

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5
Q

What are primary headaches

A

Headaches that are NOT associated with an underlying illness

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5
Q

HA health disparities affected groups

A

American Indians
African Americans
Hispanics

Poverty
Unemployed/underemployed
Uninsured/underinsured

People exposed to stress across an extended time period

People experiencing more than one of the above

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6
Q

What are medication overuse headaches considered

A

Secondary

(Stressed this in class — makes sense because it has a direct cause)

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7
Q

What percentage of HAs are primary HAs

A

~90%

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7
Q

Examples of primary headaches

A

Episodic and chronic tension HA
Migraine (with/without aura)
Cluster HAs

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8
Q

What are secondary HAs

A

Symptomatic of an underlying condition such as:

Trauma
Stroke
Substance use/withdrawal
Bacterial and viral diseases
Craniofacial disorders

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9
Q

Lifestyle modifications

A
  • Stress management
  • Cognitive therapy
  • Maintaining schedules for: sleep, exercise, and eating
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9
Q

Types of headaches for self treatment

A

Tension
Migraines
Sinus (simple/minor)

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10
Q

Patient education for HA

A

Types of headaches/diagnosis
Safe medication use
Lifestyle modifications

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10
Q

HA treatment goals

A
  1. Alleviate acute pain
  2. Restore normal functioning
  3. Prevent relapse
  4. Minimize adverse effects
  5. Reduce frequency of headaches (for chronic)
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11
Q

_______ has shown evidence in helping headaches

A

Acupuncture

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12
Q

What should be included in a HA diary

A

Related symptoms
Duration
Frequency
Triggers
Medications that did/didn’t work
Menstruation

***keep for at least 8 weeks

(Really Down For The Moment, Man)

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13
Q

Nonpharmacologic therapy for headache

A

Pt education
Acupuncture
HA diary

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13
Q

Pressure points for HA relief

A

Daith ear piercing
Acupuncture in ear

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14
Q

Tension headache pathophysiology

A
  • Response to stress, anxiety, depression, emotional conflict
  • Mechanisms are not fully understood
  • Genetic and environmental factors involved
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15
Q

The mechanisms of tension HAs are not fully understood. What are they thought to be related to?

A

Increased sensitivity of central and peripheral pain receptors

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16
Q

What determines if tension headaches are chronic

A

Occur 15+ DAYS per month for at least 3 months

*Stressed that it is measured in days, not # of HAs

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17
Q

What determines if tension headaches are episodic

A

Occur LESS THAN 15 days per month

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18
Q

What determines if HAs are FREQUENT episodic

A

10+ episodes per month

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19
Q

What determines if HAs are INFREQUENT episodic

A

1 or fewer episodes per month on average

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20
Q

When do tension headaches typically begin

A

Usually during teenage years

Women are more likely to be affected (3:2)

21
Q

Tension HA location

A

Bilateral

22
Q

Tension HA Nature

A

Diffuse HA
Tightening
Pressing
Constricting
Non-pulsating

23
Q

Tension HA Duration

A

30 min - 7 days

24
Q

Tension HA Aggravating factors

A

Stress
Anxiety

25
Q

Tension HA Intensity

A

Mild-moderate

26
Q

Tension HA Onset

A

Gradual

27
Q

Tension HA Other symptoms

A

Scalp tenderness
Neck pain
Muscle tension
Photo OR phonophobia

(Sore Neck Muscles, Probably)

28
Q

Treatment of episodic tension HAs

A

Analgesics
Nonpharmacologic treatment
Combination therapy

29
Q

Analgesics for treatment of episodic tension HAs

A

Aspirin (Bayer)
OTC and Rx options
NSAIDs:
- ibuprofen (advil, motrin)
- naproxen (aleve)

30
Q

What is the max self care duration for episodic tension HAs? What is the reason for this max?

A

3 days per week or 15 days per month

Max exists to prevent medication overuse/chronic tension HA

31
Q

Nonpharmacologic treatment for episodic tension HAs

A

Correct posture
Relaxation techniques
Alternative medicine
Physical therapy

(CRAP)

32
Q

Alternative medicine for treatment of episodic tension HAs

A

Acupuncture
Massage
Deep breathing/behavioral therapy

33
Q

Combination therapies for treatment of episodic tension HAs

A

Combo of aspirin, APAP, ibuprofen, and caffeine

This is more effective than just APAP

34
Q

Maximum self care use of combination therapies for treatment of episodic tension HAs

A

10 days/month

35
Q

Which of the following is a symptom of a tension-type headache

Unilateral pain
Nausea
Sharp pain
Pressure wrapping around the head

A

Pressure wrapping around the head

36
Q

To qualify as a migraine (withOUT aura), what characteristics must be present

A

At least two of the following:
- Unilateral
- Moderate to severe head pain
- Pulsating
- Aggravation by routine physical activity

At least one of the following:
- Photophobia/phonophobia
- Nausea/vomiting

37
Q

Before a migraine can be self treated, what must the patient have

A

Medical diagnosis of migraines

38
Q

Migraine WITH aura

A

Patients experience neurologic signs/symptoms that precede or coincide w/ the onset of head pain and then resolve fully

39
Q

Neurologic manifestations of migraines WITH aura

A
  • Ocular perceptions of shimmering/flashing areas or blind spots
  • Difficulty speaking (rare)
  • Visual and auditory hallucinations
  • Muscle weakness (usually one sided)

(Our Damn Vicious Migraines)

40
Q

How long can neurologic symptoms of migraines WITH aura last

A

Neurologic symptoms may last up to 60 minutes

Subsequent head pain lasting hours-days

41
Q

When is a migraine considered to have aura

A

In patients with or without headache if neurologic symptom:
- develops slowly over 5 min
- lasts 5-60 min
- resolves completely

41
Q

For migraines WITH aura, head pain does NOT ________

A

Have to follow aura signs

42
Q

If a patient is having a migraine, how might they describe the pain

A

As being one side of the head (unilateral)

43
Q

phases of a migraine in order

A

Prodrome
Aura
Headache
Postdrome

(Pretty Awful Headaches, Pal)

44
Q

Prodrome/premonitory

A

Pre-headache

Can being hours to days before headache

One or more signs occurring before clinical onset of migraine (ie head pains)

45
Q

Prodrome/postdrome signs

A

Food cravings
Yawning
Neck pain/stiffness
Hyperactivity/hypoactivity
Fatigue
Depression

(Fuck Your New Hoe For Days)

45
Q

Aura

A

No headache pain

Usually evolves over 5 minutes and lasts 60 min

Does not have to occur with every headache

46
Q

Postdrome

A

Recovery period/migraine hangover

Not experienced by everyone

One or more signs occurring after the migraine episode (after pain is fading or gone)

46
Q

Headache

A

Lasts several hours to days

Pain levels vary

Pain can shift from one side of the head to the other

47
Q

Migraine triggers

A

Dehydration
Hormonal changes
Miscellaneous
Environmental
Food/diet

(Don’t Have Migraines Every Friday)

48
Q

Migraine triggers: dehydration

A
  • major cause
  • address dehydration for all patients, especially children
49
Q

Migraine triggers: Hormonal changes

A
  • menopause and menstruation
  • medications such as hormonal contraceptives/other hormone therapies
50
Q

Migraine triggers: Food/diet

A
  • MSG
  • Nitrates (cured meats)
  • Caffeine/caffeine withdrawal
  • Saccharin/aspartame (phenylalanine)
  • Fermented/pickled foods
  • Alcohol
  • Chocolate (theobromines)
  • Tyramine (red wine, aged cheeses
  • Skipping meals/ low blood sugar

(Might Not Catch Straight FACTS)

51
Q

Migraine triggers: Environmental

A
  • Fumes/odors (cleaning solution, paints, gas)
  • Tobacco smoke
  • Noises
  • Fragrances
  • Allergies
  • Weather changes
  • Bright lights
  • High altitudes

(Fuck Those New Fake Ass Wanna Be Hoes)

52
Q

Migraine triggers: Miscellaneous

A

Sleep deprivation or excess
Head trauma
Anxiety
Physical exertion
Eye strain
Stress/post stress (most common)

(SHAPES)

52
Q

Preventative treatments for migraines

A

Daily therapy to reduce frequency, severity, and duration

Patients w/ frequent HA may need both preventative and acute therapies

NOT self treatments (require rx)

53
Q

Preemptive care for migraines

A

Used when known trigger exists

Ex. Menstruation

53
Q

Acute care for migraines

A

Medications may be taken during the attack

Used to relieve pain and stop progression

May be best treatment plan in HA are infrequent, pt is non-compliant, or preventative treatment is not tolerated

OTC (31 decks)

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