Neurology I Txs Flashcards
How do you Tx coma?
1) Support
2) Correct any of the abnormalities found during assessment.
3) Thiamine, dextrose, or naloxone can be given IV without awaiting lab results
What do you need to repeat when a pt is in a coma?
Neurological checks
What 3 things can you do to Tx coma before labs get back?
Thiamine, dextrose, or naloxone
How do you Tx subdural hematomas?
Admit to hospital and neurosurgery consult
How do you Tx minimally conscious pts?
1) Underlying cause – if able
2) Amantadine
How to Tx cluster headaches?
High flow O2 via non-rebreather mask
How to Tx migraines?
acute – early use of high dose NSAIDs (though must weigh risks/benefits)
Triptans** preferred nasal sprays or injections can be used in patients with n/v
CONTRAINDICATED in CAD and cerebrovascular disease
Combo therapy highest yield *NSAIDs + triptans) can also add metoclopramide or Compazine in pts with n/v as well
Goal of migraine Tx?
goal – eliminate pain and assoc symptoms without increasing disability. (ex/ avoid sedation;) early intervention; avoid known triggers
How to Tx tension headaches?
NSAIDs, nonpharmacologic interventions (acupuncture, massage, trigger point injections, PT)
* Note, Botox does not work here*
Dizziness:
1) How do you Tx?
2) What are last resort Txs?
1) Treat any underlying disorders, vestibular suppressant (meclizine), antiemetics, vestibular rehab
2) Intratympanic injections, surgery
How do you Tx vertigo?
Tx underlying cause
How do you Tx CN palsies?
Decompression surgery, B vitamins 6, 12, correct underlying cause if able
How to Tx bells palsy?
60% spontaneously resolve
1) Prednisone 60 mg PO QD x 5d followed by 5d taper increases the chance of complete recovery by 1 yr
2) Acyclovir or Valacyclovir if presence of herpetic vesicles in EACs
3) Lubricating eye drops
How to Tx bulbar palsy?
1) Treat underlying disorder
2) Refer to neurology
3) Riluzole PO BID, Edaravone > meds not on exam
