Headaches

Question 1

Benign types of headaches

Answer 1

Cluster - Pain in & around 1 eye
Migraine - Pain, nausea, visual changes
Tension- Pain like a band, squeezing
Sinus - Pain behind browbone/cheekbone

Question 2

Management for Migraines

Answer 2

Mild- NSAIDS, tylenol, Caffeine
Severe- Triptans/ relieve HA and other symptoms by activating serotonin receptors to produce a vasoconstrictive effect. (Zomig, Relpax, Imitrex)
Contraindicated in ischemic heart disease, HTN and PVD, Prinzmetal’s Angina
Report chest pain
may have flushing, tingling, hot sensations
avoid if on SSRIs, or MAOIs (serotonin syndrome)

Question 3

Preventative Therapy for Migraines

Answer 3

NSAIDS
Beta Blockers - Inderal - take every day, dont stop abruptly, dont give with asthma
Side effects- sexual libido decreased
Can take calcium blockers
Topamax most common, should be used in low doses

Question 4

Foods to avoid with Migraines

Answer 4

Tyramine containing foods such as, Pickled products, caffeine, beer, wine, preservatives artificial sweeteners

Question 5

Cluster headaches

Answer 5

Occur more in middle-aged men than women
Pt may rock or pace
Unilateral, behind eye
Onset assoc with napping, relaxation, REM
occurs in clusters avg duration 30-90 min

Question 6

Treatment for Cluster headaches

Answer 6

100% O2 for 7-10 min while pt in sitting position,

Triptans (Imitrex) and other drugs used with migraines

Question 7

Cluster HA usually occurs with

Answer 7

Ptosis
same side tearing of the eye
runny nose
eyelid edema
facial sweating
constriction of pupils

Question 8

Tension HA

Answer 8

Most common long duration type of HA
Neck, shoulder tenderness, bilat pain at base of skull and forehead
similar to migraines