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Over The Counter > Headache > Flashcards

Headache Flashcards

1
Q

What is the most common headache type seen in community?

A

Tension-type headache

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2
Q

What are the second most likely causes of headache seen in the community?

A

Migraine, sinusitis, eye strain.

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3
Q

What are some unlikely causes of headache seen in community?

A

Cluster headache, medication-overuse headache, temporal arteritis, trigeminal neuralgia, depression

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4
Q

What are the least likely causes of headache seen in the community?

A

Gluacoma, meningitis, subarachnoid haemorrhage, raised intracranial pressure.

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5
Q

Tension-type headaches can be classed as either episodic or what?

A

Chronic.

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6
Q

Pain is biocciptal, generalised and non-throbbing describes what headache?

A

Tension-type.

Patient may describe the pain as tightness or a weight pressing down on their head.

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7
Q

A patient might describe what type of headache as tightness or a weight pressing down on their head?

A

Tension-type

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8
Q

Pain which is gradual in onsent and tends to worsen progressively through the day describes what headache?

A

Tension-type.

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9
Q

Temporal location of pain implies what headache?

A

Migraine, temporal arteritis.

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10
Q

Occipital location of pain (back of the head) describes what type of headache?

A

Subarachnoid haemorrhage tension headache

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11
Q

Orbital (eye) location of pain in headache is what?

A

Cluster, glaucoma, sinusitis.

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12
Q

An onset of headache symptoms for the first time after 50 years of age indicates what?

A

A much greater likelihood of a secondary cause of headache.

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13
Q

Cluster headache is nearly always unilateral in what areas?

A

Frontal, ocular or temporal areas.

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14
Q

Tension-type headache is often bilateral in what areas and described as what?

A

Tension-type headache is often bilateral, either in frontal or occipital areas, and described as a tight band.

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15
Q

Severe to intense ache of throbbing suggests what type of head disorder?

A

Haemorrhage or aneurysm

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16
Q

Piercing, boring, searing eye pain suggests what?

A

Cluster headache

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17
Q

Moderate to severe throbbing pain that often starts as a dull ache suggests what?

A

Migraine

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18
Q

Headache pain that worsens on exertion, coughing or bending suggests what?

A

Tumour

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19
Q

Lying down typically makes what type of headache worse?

A

Cluster

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20
Q

Cluster headaceh will only last how long normally?

A

2 to 3 hours

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21
Q

Tension-type headaches last between a few hours and what?

A

Several days, e.g a week or more

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22
Q

Any food can be a potential headache trigger, but food implicated includes:

A

Cheese
Citrus fruit
Chocolate

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23
Q

Headache with aura can be what two types?

A

Visual or neurological

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24
Q

Visual aura includes

A

Scotomas (blind spots)
Fortification spectra (zig-zag lines)
Flashing or flickering lights

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25
Q

Neurological aura includes

A

Pins and needles in the hand, migrating up the arm before jumping to the face and lips.

26
Q

Within 60mins of the aura ending, what occurs?

A

The headache.

27
Q

Cluster headache is predmoninatly a condition that occurs in what?

A

Men over 30.

28
Q

Why is referral needed in cluster headache?

A

The drug of choice, sumatriptan, does not have an OTC license for cluster headache.

29
Q

What characterises cluster headache? (3)

A
  1. Headache occurs the same time each day with abrupt onset and lasts between 10 minutes and 3 hours.
  2. 50% of patients experience night-time symptoms: patients are woken 2 to 3h after falling asleep with very intense unilateral orbital boring pain.
  3. Periods of acute attacks, typically lasting a number of weeks to a few months with sufferers experiencing between one to three attacks per day.
30
Q

What is medication-overuse headache?

A

Pain receptors are switched on instead of being switched off.

The consequence is a cycle where patietns take more and more painkillers that are stronger and stronger in order to control the pain.

Patients will experience daily or near daily headaches that are described as dull and nagging.

31
Q

What is temporal arteritis?

A

The temporal arteries that run vertically up the side of the head, just in front of the ear, can become inflamed. When this happens, they are tender to touch and might be visibly thickened. Unilateral pain is experienced and the person generally feels unwell with fever, myalgia and general malaise.

Scalp tenderness is also possible, especially when combing the hair. It is most commonly seen in the elderly, especially women.

Prompt treatment with oral corticosteroids is required as the retinal artery can become compromised, leading to blindness. Urgent referral is needed.

32
Q

How is temporal arteritis treated?

A

Oral corticosteroids.

The retinal artery can become compromised, leading to blindness.

Most commonly seen in the elderly, especially women.

33
Q

What does trigeminal neuralgia present as?

A

Short lived (few minutes) but lancing and severe pain following the course of either the second or third divison of the nerve leading to pain in the cheek, jaws, lips or gums.

34
Q

Pain behind both knees when extended (positive Kernig’s sign) indicates what?

A

Meningitis can present with a severe generalised headache associated with fever, an obviously ill patient, neck stiffness, pain behind both knees when extended (positive kernigs sign) and laterly a purpuric rash are classically associated with menigitis.

35
Q

What does subarachnoid haemorrhage present as?

A

Very intense and severe pain, located in the occipital region.

Nausea and vomiting, decreased consciousness, ‘worst headache they have ever experience’

36
Q

Headache in children under 12 who have a stiff neck or skin rash

A

Refer as possible meningitis

37
Q

Headache occurs after recent (1-3 months) trauma injury could be

A

Haematoma

38
Q

Headache lasting longer than how long should be referred?

A

More than 2 weeks.

39
Q

Migraleve pink contains

A

Paracetamol
Codeine
Buclizine

40
Q

Migraleve yellow contains

A

Para and cod

41
Q

Buccastem M contains

A

Prochloperazine which has been found to be a potent antiemetic in a number of conditions, including migraine.

It works by blocking dopamine receptors found in the chemoreceptor trigger zone.

It is administered via the buccal mucosa and therefore patients will need to be counselled on correct administration.

42
Q

How does Buccastem M work in treating migraine symptoms?

A

IT works by blocking dopamine receptors found in the chemoreceptor trigger zone.

43
Q

What is the active of imigran?

A

Sumatriptan.

Triptans are 5HT1 agonists and stimulate 5HT1B and 5HT1D receptors causing constriction of the cranial blood vessels, stop the release of inflammatory neurotransmitters at the trigeminal nerve synapses and reduce pain signal transmission.

44
Q

How do sumatriptans (Imigran Recovery etc.) help migraines?

A

Triptans are 5HT1 agonists and stimulate 5HT1B and 5HT1D receptors causing constriction of the cranial blood vessels, stop the release of inflammatory neurotransmitters at the trigeminal nerve synapses and reduce pain signal transmission.

45
Q

Migraleve is recommended for children aged __ and over. The dose for adults and children over 14 is ___ Migraleve Pink tablets taken when ________

A

10 and over.
Adults and 14 and over is two Migraleve Pink tablets when the attack is imminent or begun.

If further treatment is required, one or two Migraleve Yellow tablets can be taken every 4h.

46
Q

The Migraleve dose for children aged between 10 and 14 is

A

half that of the adult dose, so it is ONE (adult: two) Migraleve Pink tablet when the attack is imminent or begun, then a maxikum three migraleve yellow tablets (one every four hours).

47
Q

The buclizine component of Migraleve Pink tablets can cause what side effects?

A

Drowsiness and antimuscarinic effects,

48
Q

Is Migraleve safe in pregnancy?

A

Yes but because of the codeine component, it is best avoided in the 3rd trimester.

49
Q

Is Migraleve safe in breastfeeding?

A

Generally but drowsiness in babies breasfed has been reported.

50
Q

Buccastem M is indicated for what?

A

Previously diagnosed migraine sufferers aged 18 years and over who experience nausea and vomiting.

51
Q

The usual dose for Buccastem M is one or two tablets twice daily. Side effects include what?

A

Drowsiness, dizziness, dry mouth, insomnia, agitation and mild skin reactions.

52
Q

Is Buccastem M safe in pregnancy?

How about breast feeding?

A

Safely used in pregnancy, but the manufacturer advises avoidance unless absolutely necessary.

Minimal prochlorperazine passes into the breast milk and it could be safely used.

53
Q

How should Imigran be taken? by who?

A

Imigran recovery can be used by patients over 18 but younger than 65 as a single 50mg tablet as soon as possible after the onset of a headache. If the headache clears and then recurs a second tablet can be taken, provided there was a response to the first tablet and more than 2 hours have elapsed between the first and second tablet.

54
Q

Imigran recovery can be used by patients ______ but younger than __ as a single __mg tablet as soon as possible after the onset of a headache. If the headache clears and then recurs a second tablet can be taken, provided there was a response to the first tablet and more than _ hours have elapsed between the first and second tablet.

A

Imigran recovery can be used by patients over 18 but younger than 65 as a single 50mg tablet as soon as possible after the onset of a headache. If the headache clears and then recurs a second tablet can be taken, provided there was a response to the first tablet and more than 2 hours have elapsed between the first and second tablet.

55
Q

What are the drug interactions of note with migraleve?

A

Increased sedation with alcohol, opioid analgesics, anxiolytics, hypnotics and antidepressants.

56
Q

What are the drug interactions of note with Buccastem M?

A

Increased sedation with alcohol, opioid analgesics, anxiolytics, hypnotics and antidepressants.

57
Q

What are the drug interactions of note with Imigran Recovery?

A

MAOIs, ergotamine.

58
Q

Buccastem M: patients in which care exercised

A

Patients with Parkinson’s disease, epilepsy and glaucoma

59
Q

Migraleve: patients in which care exercised

A

Glaucoma, prostate enlargement

60
Q

Imimgran Recovery: patients in which care exercised

A

Avoid triptans in people with a previous MI, IHD, TIA, peripheral vascular disease, cardiac arrhythmias, hypertension, history of seizures, hepatic and renal impairmen; atypical migraines.

61
Q

What are the administration directions of Buccastem M/buccal tablets?

A
  1. Place the tablet either between the upper lip and gum above the front teeth or between the cheek and upper arm.
  2. Allow the tablet to dissolve slowly. The tablet will soften and form a gel-like substance after 1 to 2 hours.
  3. The tablet will take between 3 to 5 hours to completely dissolve. If food or drinks are to be consumed in this time, place the tablet between the upper lip and gum, above the front teeth.
    4 The tablets should not be chewed, crushed or swallowed.
  4. Touching the tablet with the tongue, or drinking fluids can cause the tablet to dissolve faster.

Over The Counter (61 decks)

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