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OTC + Legal/Ethics > Headaches > Flashcards

Headaches Flashcards

1
Q

What are the symptoms of tension headaches?

A

Bilateral feeling of heaviness, pressure or tightness that “extends like a band around the head” which can also affect the upper part of the neck.

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2
Q

Do tension headaches require a counselling room?

A

No

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3
Q

What are 12 red flags for referral with tension headaches?

A
  1. Children < 12 and adults with new symptoms > 50
  2. Associated with injury/trauma
  3. Severe and last > 4hrs
  4. Severe occipital headache (across back of head)
  5. Worse in morning then improves
  6. Associated drowsiness, visual disturbance or vomiting
  7. Neck stiffness
  8. Frequent migraines
  9. OTC treatment resistant
  10. Medication induced (for example, pill)
  11. Starts after exercise, sex, straining or coughing
  12. Cluster headache.
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4
Q

What are the symptoms of cluster headache?

A

Orbital pain often worse at night and associated with conjunctivitis and nasal congestion on the same side of the head as the headache

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5
Q

Do tension headaches have a PSA self-care card?

A

Yes (headache)

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6
Q

What is the preferred treatment option for tension headaches?

A

Paracetamol

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7
Q

What are the directions for paracetamol in tension headaches?

A

15mg/kg (to a maximum of 1g) every 4 to 6 hours when required. Maximum of FOUR doses (up to 4g) in 24 hours.

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8
Q

What are 2 non-preferred options for tension headaches and why?

A
  1. Ibuprofen (greater risk of side effects)
  2. Diclofenac (greater risk of side effects)
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9
Q

Is paracetamol safe in pregnancy?

A

Yes

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10
Q

Is paracetamol safe in breastfeeding?

A

Yes

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11
Q

What is the age range for paracetamol?

A

Safe in children over 1 month

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12
Q

What are 8 pieces of non-pharmacological advice for tension headaches?

A
  1. Keep a headache diary detailing time of headache/migraine, drugs and dosages used, response to treatment and what may have triggered attack.
  2. Practice relaxation exercise.
  3. Exercise regularly.
  4. Eat a well-balanced, regular diet.
  5. Drink plenty of water.
  6. Get adequate sleep.
  7. Avoid triggers
  8. Physical therapy such as massage or stretching, heat and postural correction can help with symptoms.
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13
Q

How should you always follow up with a patient with a headache?

A

Advise patient to talk to their doctor if:
1. Warning signs or additional symptoms develop.
2. Migraine persists for > 3 days.
3. Analgesics fail or have been tried before unsuccessfully.

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14
Q

What are the symptoms of migraines?

A

Recurrent episodes of throbbing head pain, often unilateral (but often swaps sides between attacks). Pain is severe and limits or stops activity and is usually associated with nausea, vomiting and/or photophobia. Migraines may be preceded by aura (usually visual disturbances such as flickering lights, zigzag lines, loss of part or all vision).

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15
Q

Do migraines require a counselling room?

A

No

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16
Q

What are 12 red flags for referral with migraines?

A
  1. Children < 12 and adults with new symptoms > 50
  2. Associated with injury/trauma
  3. Severe and last > 4hrs
  4. Severe occipital headache (across back of head)
  5. Worse in morning then improves
  6. Associated drowsiness, visual disturbance or vomiting
  7. Neck stiffness
  8. Frequent migraines
  9. OTC treatment resistant
  10. Medication induced (for example, pill)
  11. Starts after exercise, sex, straining or coughing
  12. Cluster headache.
17
Q

Do migraines have a PSA self-care card?

A

Yes (Migraine)

18
Q

What is the preferred treatment option for migraines?

A

Soluble paracetamol

19
Q

What are the directions for paracetamol in migraines?

A

15mg/kg (to a maximum of 1g) dissolved in a glass of water every 4 to 6 hours when required. Maximum of FOUR doses (up to 4g) in 24 hours.

20
Q

What are 4 non-preferred options for migraines and why?

A
  1. Ibuprofen (greater risk of side effects)
  2. Diclofenac (greater risk of side effects)
  3. Paracetamol 500mg/Metoclopramide 5mg (Anagraine): should be avoided in Parkinson’s Disease
  4. Triptans: only for acute relief of migraine in patients who have a stable, well-established pattern of migraine symptoms.
21
Q

Is paracetamol safe in pregnancy?

A

Yes

22
Q

Is paracetamol safe in breastfeeding?

A

Yes

23
Q

What is the age range for paracetamol?

A

Safe in children over 1 month

24
Q

What are 9 pieces of non-pharmacological advice for migraines?

A
  1. Keep a headache diary detailing time of headache/migraine, drugs and dosages used, response to treatment and what may have triggered attack.
  2. Practice relaxation exercise.
  3. Exercise regularly.
  4. Eat a well-balanced, regular diet.
  5. Drink plenty of water.
  6. Get adequate sleep.
  7. Avoid triggers
  8. Physical therapy such as massage or stretching, heat and postural correction can help with symptoms.
  9. Patients with migraine can be advised to rest in a quiet, darkened room and to avoid movement/activity i.e., reading or watching TV.
25
Q

What are 7 potential triggers for migraines?

A
  1. Stress/tension/anxiety.
  2. Caffeine/alcohol/smoking.
  3. Fasting, delaying or missing meals.
  4. Dehydration
  5. Bright/flickering lights
  6. Strong fumes/smells
  7. Any known triggers specific to the patient
26
Q

When should patients start treat for migraine?

A

Initiate treatment at first signs of migraine

27
Q

What are the symptoms of sinus headaches?

A

Headaches associated with an upper respiratory tract infection, typically worsened by tilting head forward.

28
Q

Do sinus headaches require a counselling room?

A

No

29
Q

What are 12 red flags for referral with sinus headaches?

A
  1. Children < 12 and adults with new symptoms > 50
  2. Associated with injury/trauma
  3. Severe and last > 4hrs
  4. Severe occipital headache (across back of head)
  5. Worse in morning then improves
  6. Associated drowsiness, visual disturbance or vomiting
  7. Neck stiffness
  8. Frequent migraines
  9. OTC treatment resistant
  10. Medication induced (for example, pill)
  11. Starts after exercise, sex, straining or coughing
  12. Cluster headache.
30
Q

Do sinus headaches have a PSA self-care card?

A

Yes (Headache)

31
Q

What is the preferred treatment option for sinus headaches?

A

Paracetamol

32
Q

What are the directions for paracetamol in sinus headaches?

A

15mg/kg (to a maximum of 1g) every 4 to 6 hours when required. Maximum of FOUR doses (up to 4g) in 24 hours.

33
Q

What are 2 non-preferred options for sinus headaches and why?

A
  1. Ibuprofen (greater risk of side effects)
  2. Diclofenac (greater risk of side effects)
34
Q

Is paracetamol safe in pregnancy?

A

Yes

35
Q

Is paracetamol safe in breastfeeding?

A

Yes

36
Q

What is the age range for paracetamol?

A

Safe in children over 1 month

37
Q

What are 8 pieces of non-pharmacological advice for sinus headaches?

A
  1. Keep a headache diary detailing time of headache/migraine, drugs and dosages used, response to treatment and what may have triggered attack.
  2. Practice relaxation exercise.
  3. Exercise regularly.
  4. Eat a well-balanced, regular diet.
  5. Drink plenty of water.
  6. Get adequate sleep.
  7. Avoid triggers
  8. Physical therapy such as massage or stretching, heat and postural correction can help with symptoms.

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