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N4: Test 2 > Headache > Flashcards

Headache Flashcards

1
Q

What is another name for headaches?

A

Cephalgia

The term ‘cephalgia’ is derived from Greek roots meaning ‘head pain’.

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2
Q

What are primary headaches?

A

Headaches with no known organic cause, including:
* Migraine
* Tension headache
* Cluster headache

“Just my head hurts”

Primary headaches are often considered ‘functional’ as they are not attributed to any underlying medical condition.

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3
Q

What are secondary headaches?

A

Headaches that are a symptom related to a medical condition, such as:
* Brain tumor
* Aneurysm
* Sinus infection
* CVA (Cerebrovascular Accident)
* Neck injury

something else is causing pain

Secondary headaches are considered ‘organic’ and indicate an underlying health issue.

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4
Q

True or False: Headaches can interfere with activities and lifestyle.

A

True

The discomfort caused by headaches can significantly impact daily functioning.

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5
Q

Fill in the blank: Primary headaches are also known as _______.

A

Functional

This term reflects the lack of an identifiable organic cause.

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6
Q

Fill in the blank: Secondary headaches are also known as _______.

A

Organic

This term indicates that they are caused by an underlying medical condition.

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7
Q

What types of headaches fall under the category of primary headaches?

A

The types include:
* Migraine
* Tension headache
* Cluster headache

Each type has different characteristics and treatment options.

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8
Q

What can cause secondary headaches?

A

Medical conditions such as:
* Brain tumor
* Aneurysm
* Sinus infection
* CVA
* Neck injury

Identifying the cause is essential for proper treatment.

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9
Q

What is the significance of headaches in terms of physical complaints?

A

They are one of the most common physical complaints.

This prevalence highlights the importance of understanding headache types and treatments.

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10
Q

What treatment modality may be beneficial to more than one headache type?

A

Botulinum toxin

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11
Q

True or False: Botulinum toxin is effective only for migraine headaches.

A

False

  • Botulinum toxin has been found to work on BOTH tension type and migraine headaches.
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12
Q

Fill in the blank: _______ toxin has been found to work on both tension type and migraine headaches.

A

Botulinum

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13
Q

What are some types of headaches that do not require medical attention?

A
  • Hangovers
  • Caffeine withdrawal
  • Med withdrawal like fluoxetine
  • Medication Overuse Headache (MOH)

These headaches are often manageable with home care and may not indicate a serious underlying condition.

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14
Q

Headaches are the most common side effect associated with what medications?

A

Erectile dysfunction

This statistic highlights the prevalence of side effects in users of erectile dysfunction medications.

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15
Q

True or False: All headaches require medical attention.

A

False

Many headaches can be treated at home and do not necessitate professional medical intervention.

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16
Q

What type of headache involves pain in and around one eye?

A

Cluster headache

Cluster headaches are characterized by severe pain localized to one side of the head, often around the eye.

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17
Q

What is the typical sensation described in a tension headache?

A

Pain like a band squeezing the head

Tension headaches are often described as a tightness or pressure around the head.

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18
Q

What symptoms are commonly associated with a migraine?

A

Pain, nausea, and visual changes

Migraines can also include symptoms such as sensitivity to light and sound.

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19
Q

Fill in the blank: The classification of headaches includes _______.

A

cluster, tension, and migraine

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20
Q

What is the first step in the assessment of headache?

A

A detailed description of the headache is obtained

This includes specifics such as location, duration, and intensity.

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21
Q

What should be included in the patient’s history during headache assessment?

List 4

A

Medication use & history, exposure to toxins, stress and coping, family history

These factors can influence headache occurrence and management.

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22
Q

How do types of headaches manifest?

A

Differently in different persons; symptoms in one individual may also change over time

This variability can complicate diagnosis and treatment.

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23
Q

True or False: Most headaches indicate serious disease.

A

False

Although most headaches are benign, persistent headaches require investigation.

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24
Q

What is a key reason to investigate persistent headaches?

A

They may indicate underlying serious conditions

Regular assessment is important for effective management.

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25
Q

What does the choice of medication depend on?

A

Type of headache

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26
Q

What is the primary goal of headache medication?

A

To reduce the frequency and severity or stop headache

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27
Q

True or False: It is safe to use vasoactive medications in all patients.

A

False

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28
Q

Caution is advised when using vasoactive medications in __ patients.

A

cardiac

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29
Q

What is a cluster headache?

A

A rare, primary headache disorder that consists of severe headaches on one side of the head.

Cluster headaches are characterized by their intensity and specific symptoms.

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30
Q

What are common symptoms associated with cluster headaches?

List 4

A

Symptoms include:
* Red or teary eyes
* Runny or stuffy nose
* Flushing or sweating of the face
* Sense of restlessness and agitation

These symptoms help differentiate cluster headaches from other types of headaches.

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31
Q

True or False: Cluster headaches occur on both sides of the head.

A

False

Cluster headaches typically affect only one side of the head.

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32
Q

Where is the pain typically located during a cluster headache?

A

Site: Unilateral, radiating up or down from one eye

This unilateral nature distinguishes cluster headaches from other headache disorders.

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33
Q

What is the quality of pain experienced in cluster headaches?

A

Sharp, stabbing

This specific quality of pain is a key feature of cluster headaches.

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34
Q

How frequently do cluster headaches occur?

A

They may occur 1-8 times per day over a period of 2 weeks to 3 months, with months or years between attacks.

The episodic nature of cluster headaches can lead to significant distress for sufferers.

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35
Q

True or False: Cluster headaches can occur bilaterally.

A

False

Cluster headaches are characterized by unilateral pain, typically affecting one side of the head.

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36
Q

Which lifestyle factors are associated with cluster headaches?

A

Smoking and alcohol ingestion
* These factors may trigger or exacerbate cluster headaches.

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37
Q

In which population are cluster headaches more common?

A

More common in men between ages 20-40

This demographic shows a higher incidence of cluster headaches compared to women.

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38
Q

What is the duration range of a cluster headache episode?

A

5 min - 3 hrs

Cluster headaches can vary significantly in duration from a few minutes to several hours.

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39
Q

What is the symptomatic treatment for cluster headaches?

(Treating the symptom)

A
  • Oxygen
  • sumatriptan (Imitrex)
  • ergotamine tartrate (Cafergot, Ergomar)

Oxygen should be administered at 100% @ 6 to 8 liters per minute for 10 - 15 minutes.

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40
Q

What is the recommended administration for oxygen in cluster headache treatment?

A

100% @ 6 to 8 liters min for 10 - 15 minutes

This method helps alleviate symptoms during an attack.

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41
Q

Name a medication used for symptomatic relief of cluster headaches.

A

Sumatriptan (Imitrex)

Sumatriptan is a common triptan used to treat acute cluster headaches.

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42
Q

What is ergotamine tartrate used for?

A

Symptomatic treatment of cluster headaches

Available under the brand names Cafergot and Ergomar.

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43
Q

Another name for Ergotamine tartrate medication

A

cafergot

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44
Q

List 6 prophylactic medications for cluster headaches.

A
  • α-Adrenergic blocker (ergotamine)
  • Serotonin antagonist
  • Corticosteroids
  • Calcium channel blockers
  • Lithium
  • Biofeedback

These treatments aim to prevent the occurrence of cluster headaches.

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45
Q

True or False: Corticosteroids are used as a prophylactic treatment for cluster headaches.

A

True

Corticosteroids help reduce the frequency of cluster headache attacks.

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46
Q

What should ergotamine NOT be used with?

A

Serotonin receptor agonists (triptans)

Combining these medications may have additive effects and cause excessive vasoconstriction.

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47
Q

What are the additive effects of combining ergotamine with triptans?

A

Additive effects and excessive vasoconstriction

  • Vasoconstriction increases BP
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48
Q

What is the primary effect of vasoconstriction in relation to cluster headaches?

A

Vasoconstriction has been shown to minimize the headache.

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49
Q

What is the typical result of the neurological exam in tension headache diagnostics?

A

Often negative (nothing abnormal)
* dont often cause neurological deficits.

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50
Q

What should be inspected during the tension headache diagnostics?

A

Local infections

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51
Q

Q: Why is palpation important in diagnosing a tension headache?

A

A: To check for muscle tenderness or trigger points in the scalp, neck, and shoulders.

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52
Q

Q: Why is auscultation for bruits over the arteries done during a headache exam?

A

A: To listen for abnormal blood flow sounds, which could indicate vascular cause for the headache such as carotid artery stenosis.

53
Q

Which laboratory tests are commonly included in the diagnostics for tension headaches?

(List at least 4)

A
  • CBC
  • Electrolytes
  • UA
  • CT of Sinuses
54
Q

Which imaging test is specifically used to view the sinuses in tension headache diagnostics?

A

CT of sinuses

55
Q

What are the primary medications used for acute treatment of tension headaches?

A

Aspirin, acetaminophen, NSAIDs

  • These can be used alone or in combination with other medications.

These can be used alone or in combination with other medications.

56
Q

Which additional types of medications can be combined with NSAIDs for tension headache treatment?

A

Sedatives, muscle relaxants, tranquilizers

These may enhance the effectiveness of primary medications.

57
Q

Q: Why is patient education important in migraine management?

A

because migraines are often triggered by specific environmental or physiological factors, and identifying and avoiding these triggers can help with long-term management.

58
Q

What is a prodrome in the context of migraines?

A

An early symptom that may precede the onset of a migraine, indicating its approach

This phase can include sensory, motor, or psychic phenomena.

59
Q

When do migraines typically begin?

A

After awakening; they may improve with sleep

60
Q

List some associated symptoms of migraines.

A
  • Nausea/vomiting
  • Edema
  • Irritability
  • Sweating
  • Photophobia
  • Phonophobia
  • Osmophobia

These symptoms can significantly affect a patient’s quality of life.

61
Q

What percentage of patients with migraines have a family history of the condition?

A

70%

62
Q

True or False: Aura is a common symptom experienced during a migraine.

A

True

63
Q

What food is known to trigger headaches and is citrus-based?

A

Oranges

Oranges contain compounds that may provoke headaches in susceptible individuals.

64
Q

Which vegetable is listed as a potential headache trigger?

A

Tomatoes

Tomatoes can contribute to headache onset due to their natural compounds.

65
Q

Name a common ingredient in many foods that may trigger headaches, often found in processed foods.

A

Aspartame

  • Aspartame is an artificial sweetener linked to headaches in some individuals.
66
Q

Fill in the blank: _____ is a stimulant that can trigger headaches.

A

Nicotine

Nicotine may induce headaches due to its effects on blood vessels.

67
Q

List two types of foods that are known to trigger headaches due to their amine content.

A
  • Cheese
  • Chocolate

Both cheese and chocolate contain substances that may lead to headaches.

68
Q

What type of foods, commonly associated with preservation, may trigger headaches?

A

Fermented or marinated foods

These foods can contain high levels of amines, which are headache triggers.

69
Q

Fill in the blank: _______ is a common beverage that can lead to headaches when consumed excessively.

A

Caffeine

Caffeine can cause withdrawal headaches if intake is reduced suddenly.

70
Q

Which type of alcohol particularly triggers headaches?

A

Red wine

Red wine contains histamines and sulfites, which can contribute to headaches.

71
Q

True or False: Ice cream is mentioned as a potential trigger for headaches.

A

True

Ice cream can trigger headaches, possibly due to its cold temperature or dairy content.

72
Q

Name a type of food that contains nitrates and may trigger headaches.

A

Hot dogs

Nitrates are preservatives that can lead to headaches in some individuals.

73
Q

What common condiment is listed as a potential headache trigger?

A

Vinegar

Vinegar can contain compounds that may provoke headaches in sensitive individuals.

74
Q

Fill in the blank: Foods containing _______ are known to be headache triggers.

A

Monosodium glutamate

Monosodium glutamate (MSG) can cause headaches in some people after consumption.

75
Q

List 2 common dairy products that may trigger headaches.

A
  • Ice Cream
  • Cheese

Both ice cream and cheese can provoke headaches due to their dairy content.

76
Q

Q: What is the key difference between migraine with aura and migraine without aura?

A

Migrane with Aura = Aura + prodrome
Migrane without Aura = Neither

77
Q

Q: What are the characteristics of a migraine without aura?

A
  • Unilateral throbbing headache
  • Possible N/V
  • Complaints of phonophobia and photophobia.
78
Q

Q: How does a migraine WITH aura typically progress?

A

A: It starts as a unilateral throbbing headache that later becomes generalized.

79
Q

What sensory symptoms might a patient with a migraine WITH aura experience?

A

A: Visual disturbances and possible mood variations.

80
Q

What medications are used for mild migraine therapy?

A
  • acetaminophen
  • ibuprofen
  • ketorolac

These medications are considered first-line treatments for mild migraines.

81
Q

What medications are used for severe migraine therapy?

A

opioids such as codeine & meperidine

Refer to your facility formulary for specific guidelines and availability.

82
Q

What are the common antiemetics used in migraine therapy?

A
  • promethazine
  • metoclopramide
  • odansetron

Controls N/V

Antiemetics are often prescribed to help alleviate nausea associated with migraines.

83
Q

What is the purpose of prophylactic agents?

A

Prevention

Prophylactic agents are used to prevent conditions such as seizures or migraines.

84
Q

List the 6 **#1 Approach ** Prophylactic (prevention) agents for migranes

A
  • Antiseisure meds
  • Antihypertensives
  • Antidepressants
  • Serotonin antagonists
  • Botulinum Toxin A
  • Stress mgmt tecghniques
85
Q

Approach No. 1

Name 2 antiseizure agents for Migraine tx.

A
  • Valproate (Depakene)
  • Topiramate (Topamax)

Antiseizure agents are utilized to manage epilepsy and other seizure disorders.

86
Q

Approach #1:

3 Antihypertensive meds for Migraines

A
  • B-Adrenergic Blockers
  • Ca Channel Blockers
  • Potassium channel Blockers
87
Q

Migranes:

What class of medication does propranolol belong to?

A

ß -Adrenergic Blockers

  • Propranolol is commonly used to manage hypertension and anxiety.
88
Q

Migranes:

Identify a calcium channel blocker used as a prophylactic agent.

A

Verapamil

  • Calcium channel blockers are often prescribed for hypertension and certain types of arrhythmias.

Calcium channel blockers are often prescribed for hypertension and certain types of arrhythmias.

89
Q

Migranes:

What type of medication is amitriptyline?

A

Antidepressant

  • Amitriptyline is often used to treat depression and can also be effective in preventing migraines.
90
Q

Migranes:

What is an example of a serotonin antagonist?

A

Methysergide (Sansert; Deseril)

Serotonin antagonists are used to prevent migraines by blocking serotonin receptors.

91
Q

What is the role of Botulinum toxin A in treatment?

A

Chronic migraine management

Botulinum toxin A is used as a preventive treatment for chronic migraines.

92
Q

List some non-pharmacological approaches to prevent Migranes.

A
  • Stress management
  • Exercise
  • Biofeedback
  • Trigger avoidance
  • Hormones

These approaches can complement pharmacological treatments in preventing conditions.

93
Q

What are the #2 Approach Symptom Relief agents for Migranes?

List 7

A
  • a-Adrenergic blockers
  • Serotonin receptors agonists (triptans)
  • Analgesics
  • Corticosteroids
  • antiemetics
  • combination drugs
  • Gepant drugs
94
Q

What are α-Adrenergic blockers used for?

A

Symptom relief for migraines

  • Includes agents like ergotamine with caffeine (Cafergot) and DHE.

Includes agents like ergotamine with caffeine (Cafergot) and DHE.

95
Q

Name a class of drugs known as serotonin receptor agonists.

A

Triptans

  • Examples include sumatriptan (Imitrex) and zolmitriptan (Zomig).
96
Q

What is a caution to consider when prescribing sumatriptan?

A

Caution in CVD, HTN, CVA, and PVD

May exacerbate issues due to vasoactive effects.

97
Q

List some analgesics used for migraine relief.

A
  • ASA (aspirin)
  • NSAIDs

ASA refers to acetylsalicylic acid.

98
Q

What is the purpose of corticosteroids in migraine treatment?

A

Decrease inflammation

Helps in managing migraine symptoms.

99
Q

Name 2 antiemetics that can be used for migraines.

A
  • Ondansetron
  • Promethazine

Antiemetics help alleviate nausea associated with migraines.

100
Q

What are combination drugs for migraine relief?

A

α-Adrenergic blockers with triptans with analgesics with antiemetics

These combinations aim to provide comprehensive symptom relief.

101
Q

What class of drugs are Gepants?

A

CGRP – calcitonin gene-related peptide receptor antagonists

102
Q

What do Gepant drugs do?

A

They are used for migraine treatment with less vasoconstriction.

103
Q

What is a potential threat associated with gepant drugs?

A

Hepatotoxicity threat

Requires monitoring of baseline liver function tests (LFTs).

104
Q

Migranes:

Triptan Fast Onset/High Potency Meds

A
105
Q

Migranes:

Triptan Slow Onset/Low Potency

A
106
Q

What is Dihydroergotamine (DHE) used for?

A

Treats migranes

107
Q

What type of constrictor is Dihydroergotamine?

A

Venous and arterial constrictor

108
Q

What are the routes of administration for Dihydroergotamine?

A

Given IV or IM

109
Q

What is the half-life of Dihydroergotamine?

A

10-14 hour half life

110
Q

Who should not be given Dihydroergotamine?

A

Patients with cardiac history

111
Q

Is Dihydroergotamine safe to use during pregnancy?

A

Not safe during pregnancy

112
Q

What type of drug interactions may Dihydroergotamine have?

A

Interactions with ‘triptans’ that potentiate vasoconstriction

113
Q

What precautions should be taken when using Dihydroergotamine in certain patients?

A

Use with caution in ischemia and hypertensive patients

114
Q

What side effects may occur with Dihydroergotamine?

A

May cause drowsiness/dizziness

115
Q

What is the definition of migraine headaches?

A

A type of headache characterized by recurrent episodes of moderate to severe pain, often accompanied by nausea and sensitivity to light or sound.

Migraines can vary in duration and intensity.

116
Q

List three characteristics or manifestations of migraines.

A
  • Moderate to severe pain
  • Nausea
  • Sensitivity to light or sound

These symptoms can vary from person to person.

117
Q

What are common triggers of migraine headaches?

A
  • Foods containing tyramine
  • Long periods between meals
  • Menstruation and ovulation
  • Alcohol
  • Fatigue and sleep fluctuations

Identifying and avoiding these triggers can help manage migraines.

118
Q

Fill in the blank: Foods that contain _______ should be avoided to help prevent migraines.

A

[tyramine]

119
Q

What is a recommended tool for migraine management?

A

A paper or electronic headache diary.

This helps track headache patterns and triggers.

120
Q

What lifestyle changes can help minimize the frequency of headaches?

A

Stress management and lifestyle changes.

Techniques may include relaxation exercises, regular exercise, and adequate sleep.

121
Q

What should be ensured for correct pharmacologic management of migraines?

A

Acute therapy and prophylaxis, including medication regimen and understanding of side effects.

It’s important to discuss medication options with a healthcare provider.

122
Q

What comfort measures can be used during headache attacks?

A
  • Resting in a quiet and dark environment
  • Applying cold compresses to the painful area
  • Elevating the head

These measures can provide relief during an attack.

123
Q

True or False: Seeking resources for education and support is important for managing migraines.

A

True

Organizations like the National Headache Foundation can provide valuable information and support.

124
Q

What are Gepant drugs?

A

CGRP – calcitonin gene-related peptide receptor antagonists that cause less vasoconstriction

Gepants are a new class of medications used primarily for the treatment of migraines.

125
Q

list 3 CGRP Receptor Agonists “Gepant” Meds

A
  • Ubrelvy
  • nurtec ODT
  • Qulipta
126
Q

What symptoms indicate a headache may require further evaluation?

A
  • Symptoms become more severe, last longer than usual, or are resistant to medication
  • Additionally, N/V (nausea/vomiting), changes in vision, or fever occurring with the headache may signal a need for evaluation.
127
Q

What are the concerning signs that accompany headaches?

A

Drowsiness, lethargy, obtunded

These signs may indicate a more serious underlying condition related to the headache.

128
Q

Fill in the blank: A headache accompanied by _______ should prompt further assessment.

A

N/V, change in vision, fever occuring with the headache.

129
Q

Q: How can medication use contribute to headache issues?

A

Overuse of pain medications can lead to rebound headaches or drug-related complications.

This includes concerns about efficacy, side effects, and potential interactions.

N4: Test 2 (4 decks)

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