Headache management in GP Flashcards
What are potential triggers of headaches?
Stress Learning Caffeine intake Dental health Eye health Smoking
What is a good conservative management option?
Headache journal: Day & date Headache - yes or no? Time Other symptoms Triggers? Severity Medication taken? Period? (in women)
In headache management be aware of:
Exacerbation from substances including medication
Sleep
Stress
Hydration
Migraines can flare with change in routine
Medical management for headaches include?
Paracetamol
NSAIDs
Triptans e.g. sumatriptan 50-100mg in 1 dose, can repeat dose after at least 2 hours and maximum per day is 300mg
What are the contraindications of NSAIDs?
GI ulcers Renal failure Hepatic failure Heart failure During conception - miscarriage association Pregnancy
What are the contraindications of triptans?
Uncontrolled hypertension
Ischaemic heart disease
Stroke
Pregnancy - unless benefit > risk
Name three drugs used for migraine prophylaxis?
Propranolol - 80-240mg in divided doses
Amitriptyline - 50-75mg daily
Topiramate - 50-100mg daily in divided doses
What are the side effects of propranolol?
Low BP
What are the side effects of amitriptyline?
Drowsiness
What are the side effects of topiramate?
Paraesthesia
Why is topiramate contraindicated in pregnancy?
Due to teratogenesis
