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4 CNS > OTC Pain > Flashcards

OTC Pain Flashcards

1
Q

migraines usually present at what age

A

under 30

rare over 50

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2
Q

Typical symptoms of migrane

migraines are bilateral or unilateral

A

unilateral

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3
Q

what is the difference between a tension headache and sinisitis

A 
TENSION
is like a band around the head
Occipital or frontal
SINUSITUS
Frontal
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4
Q

symptoms of meningitis

A

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
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5
Q

what is the demographic mainly affected by cluster headaches

A

men aged 40 - 60

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6
Q

what are the symptoms of a cluster headache?

how to treat?

A

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

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7
Q

what are the symptoms of temporal arteritis?

how to treat?

A

severe unilateral pain and tender temple, sometimes radiating to jaw

  • refer to GP
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8
Q

What are the symptoms of subarachnoid haemorrage

A

the worst pain I’ve ever had

-refer to A&E

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9
Q

what might make you suspect a space occupying lesion

A

-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

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10
Q

symptoms of trigeminal neuralgia

A

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

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11
Q

Red flag headache symptoms

A 
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
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12
Q

NSAIDS and aspirin should be avoided in patients with what chronic condition as likely to be hypersensitive

A

asthma

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13
Q

can aspirin or ibuprofen be given to children?

A

ibuprofen yes - from 3 months

aspirin no - reyes syndrome

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14
Q

analgesics to be used with methotrexate?

A

Not NSAIDS & aspirin - can cause life threatening rise in serum levels due to reduced excretion

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15
Q

What CNS active drug means that NSAIDS should be avoided due to reduced excretion of it

A

Li

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16
Q

Can NSAIDS be used in hypertension

A

may antagonise antihypertensive and diuretic effect - not recommeded

17
Q

How long might it take for the toxic effects of paracetamol to become apparent

A

2 days or more

18
Q

can you buy dihydrocodeine over the counter

A

yes- paramol is co-dydramol

19
Q

3 disadvantages of caffeine in analgesic preparations

A

headaches, GI adverse effects, habit forming

20
Q

OTC sumitriptan is not suitable in what conditions

A

CV conditions, hypertension, peripheral vascular diease, liver, kidney disease

21
Q

What is the dose of sumitriptan?

What is the max in 24 hours?

A

50mg at onset,
second 50mg if symptoms persist after two hours
2 tabs max in 24 hours

22
Q 
referral for migraine:
if attacks last longer than .........
or
.....
or
pt over........... and suffering from first migrane
A

last longer than 24 hours
not recovering between attacks
over 50 and suffering from first migranes

23
Q

supitriptan should not be taken with what other meds

A

Basically anything for depression or migraine
SSRIs
St Johns Wort
MAOIs
Moclobemide
Other migraine treatmetns (ergotamine & methysergide)

24
Q

What is isometheotene used for

A

OTC with paracetamol for migraine and throbbing headache
sympathomimetic

Less suitable for prescribing

25
Q

What OTC antiemetic is lisenced for nausea and vomiting associated with mirgraine

when is this lisenced
Age…

A

prochlorperazine maleate (buccastem)

If migraines diagnosed by a doctor
over 18

26
Q

Prochloraperazine OTC is contraindicated in…

A 
preg and breastfeeding
hepatic dyfunction
narroe angel glaucoma
prostatic hypertrophy
epilepsy
PD
27
Q

when should toothpain be referred?

A

always- its not self limitting

-in the mean time simple analgesia, or co-codamol

4 CNS (10 decks)

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