OTC Pain Flashcards
migraines usually present at what age
under 30
rare over 50
Typical symptoms of migrane
migraines are bilateral or unilateral
unilateral
what is the difference between a tension headache and sinisitis
TENSION is like a band around the head Occipital or frontal SINUSITUS Frontal
symptoms of meningitis
headache, nausea, fever, neck stiffness, photophobia, pain behind the knees when extended
- refer child with headache and rash who cannot bend their head forwards easily
what is the demographic mainly affected by cluster headaches
men aged 40 - 60
what are the symptoms of a cluster headache?
how to treat?
same time each day, 10 mins - 3 hours
sudden onset, intense, boring in, localized around the eye
affected eye red and watery, nasal cogestion.
Lasts between weeks and months - refer immdeiately
what are the symptoms of temporal arteritis?
how to treat?
severe unilateral pain and tender temple, sometimes radiating to jaw
- refer to GP
What are the symptoms of subarachnoid haemorrage
the worst pain I’ve ever had
-refer to A&E
what might make you suspect a space occupying lesion
-like sinusitis without the infection or allergy
my start mild and get progressively worse
worse from sneezing, coughing or lying down
may be worse on waking and then ease throught the day
-refer to GP
symptoms of trigeminal neuralgia
intense sharp pain, cutting, searing
forehead or side of head around eye with redness and lacrimentation, cheek, upper or lower jaw depending on what nerve is affected
-refer to GP
Red flag headache symptoms
sudden/severe head injury long duration recurring (excluding diagnosed migraine) worsening over time n&v (unless migrane) drowsiness vision affected pupils uneven/not reacting to light under 12 (urgent if stiff neck, fever, rash) cluster headache
NSAIDS and aspirin should be avoided in patients with what chronic condition as likely to be hypersensitive
asthma
can aspirin or ibuprofen be given to children?
ibuprofen yes - from 3 months
aspirin no - reyes syndrome
analgesics to be used with methotrexate?
Not NSAIDS & aspirin - can cause life threatening rise in serum levels due to reduced excretion
What CNS active drug means that NSAIDS should be avoided due to reduced excretion of it
Li
Can NSAIDS be used in hypertension
may antagonise antihypertensive and diuretic effect - not recommeded
How long might it take for the toxic effects of paracetamol to become apparent
2 days or more
can you buy dihydrocodeine over the counter
yes- paramol is co-dydramol
3 disadvantages of caffeine in analgesic preparations
headaches, GI adverse effects, habit forming
OTC sumitriptan is not suitable in what conditions
CV conditions, hypertension, peripheral vascular diease, liver, kidney disease
What is the dose of sumitriptan?
What is the max in 24 hours?
50mg at onset,
second 50mg if symptoms persist after two hours
2 tabs max in 24 hours
referral for migraine: if attacks last longer than ......... or ..... or pt over........... and suffering from first migrane
last longer than 24 hours
not recovering between attacks
over 50 and suffering from first migranes
supitriptan should not be taken with what other meds
Basically anything for depression or migraine
SSRIs
St Johns Wort
MAOIs
Moclobemide
Other migraine treatmetns (ergotamine & methysergide)
What is isometheotene used for
OTC with paracetamol for migraine and throbbing headache
sympathomimetic
Less suitable for prescribing
What OTC antiemetic is lisenced for nausea and vomiting associated with mirgraine
when is this lisenced
Age…
prochlorperazine maleate (buccastem)
If migraines diagnosed by a doctor
over 18
Prochloraperazine OTC is contraindicated in…
preg and breastfeeding hepatic dyfunction narroe angel glaucoma prostatic hypertrophy epilepsy PD
when should toothpain be referred?
always- its not self limitting
-in the mean time simple analgesia, or co-codamol
