Heachache Lecture Flashcards
What percentage of people have headaches at some point in their life?
90%
What are primary headaches?
Tension-type
Migraine
Medication-over use
What are secondary headaches?
Sinus
- Related to another condition (head trauma, aneurysm, infection, substance abuse)
Location, nature, onset, duration of tension-type headaches
Bilateral
Diffuse aching, tight pressing, constricting pain
More gradual
Minutes to days
Location, nature, onset, duration of migraine headaches
Unilateral
Throbbing, proceeded by an aura
Sudden
Hours to 2 days
Location, nature, onset, duration of sinus headache
Face, forehead or perioribital area
Pressure behind face and eyes
With sinus symptoms
Resolves sinus symptoms
What are elclusions for self-treatment of headaches?
Severe head pain More than 10 days Last trimester Less than 7 High fever 3+ alcoholic beverages daily Secondary headache Without diagnosis of migraine symptoms
What are the nonpharmacologic treatment for tension-type headaches?
relaxation and or stretching exercises
What are the nonpharmacologic treatment for migraines?
Avoid foods or situations that can trigger migraine
Stress management, good sleep hygiene
Cold packs
What are the nonpharmacologic treatment for sinus headaches?
Treat the underlying conditions
What are pharmacologic therapies for headaches?
NSAIDs (Ibuprofen and Naproxen) Aspirin Acetaminophen Combination therapy No more than three days a week
What is the NSAIDs of MOA?
Reversibly inhibit central PG synthesis
- COX1/2
- PG reduces the sensitivity of pain receptors to pain impulses
All NSAIDs have what properties?
ANALGESIC (pain)
ANTI-INFLAMMATORY
ANTIPYRETIC (fever)
NSAIDs admin, restrictions, onset, duration of action of Ibuprofen, naproxen?
Take with food No children under 12 30 minutes Ibuprofen: 6-8 hrs Naproxen: up to 12 hrs
What are the adverse reaction to NSAIDs
Primary GI effects: dyspepsia, heartburn, nausea
Potential for GI bleeding and fluid retention (TAKE WITH FOOD)
No congestive heart failure or renal insufficiency patients
NSAIDs interact with what other drugs?
Antihypertensive meds: raise blood pressure
Alcohol: risk of GI bleeding
Blood thinners: increase bleeding
Adult dosing of Ibuprofen?
200-400 mg every 4-6 hours
Four doses a day
MAX of 1200 mg in 24 hours
Adult dosing of Naproxen?
220 mg every 8-12 hours
MAX of 660 mg in 24 hours
Pediatric dosing of ibuprofen?
Suspension 100mg/5mL Drops 50mg/1.25mL 5-10 mg/kg/dose Four doses a day Not under 2
Pediatric dosing of naproxen?
Not under 12!
Aspirin MOA?
Irreversibly inhibit PG synthesis, with effects on both COX-1/2
Peripheral action
ANALGESIC, ANTIPYRETIC, ANTI-INFLAMMATORY PROPERTIES
Aspirin admin and onset?
TAKE WITH FOOD
Depends on dosage form
Fast onset: effervescent tablets, buffered tablets, chewable tablets
Delayed: enteric-coated tablets and sustained release tablets
Aspirin adverse effects?
Bleeding
GI upset and bleeding
What drugs do aspirin interact with?
Asprin + NSAIDs = GI bleeding
- If necessary used PPI as well
Increases level of valproic acid which is used to treat seizures and behavioral disorders
