Summary worksheet week 2 Flashcards
1.
A ______________ is not associated with an underlying illness. Examples of primary headache is tension type, migraine, cluster, and medication-overuse.
primary headache
A ______________ has to do w/ an underlying condition which could be from head trauma, stroke, substance abuse, or withdrawal, could be due from some type of infection
Secondary headache
What type of headache is this?
Bilateral, Diffuse ache, tightening, pressing, constricting, intensity:mild-moderate, onset is gradual, duration: 30 minutes to 7 days, aggrativing factors: stress,anxiety; nonheadache symptoms:scalp tenderness,neck pain and muscle tension, Tx (drug, dose route, frequency, max dose): acetaminophen, NSAIDs, salicyclates
Tension type
What type of headache is this?
Usually unilateral, throbbing, pulsating, intensity: moderate-severe, onset: sudden, duration: 72 horus, aggrativing factors: physical acitivity, light, sound
nonheadache symptoms:nausea, vomiting,aura
Tx(drug, dose, route, frequency,max dose): NSAID or salicycle at onset- previous DX!
Migraine
What type of headache is this?
Face, forehead, or preorbital area; pressure behind eyes or face; intensity: mild-severe, onset: simultaneously sinus symptoms, duration:days (resolves w/sinus symptoms), aggravating factors: nasal congestion; nonheadache symtpoms: nasal congestion, nasal discharge; tx(drug, dose, route, frequency, max dose): decongestant+analgesic
Sinus headache
List the exlcusions to self-care treatment of headaches-in other words, who we are NOT making an OTC treamnt for a headache in:
_______ head pain
Headache with rapid onset of maximum pain
-Concerning change in headache pattern
*First or worst headache
*Gradual escalation over months
-Headache that persists for ______ days with or without treatment
-Age <8 years
-High fever or sign of serious infection
-Neck stiffness
-Neurologic change (visual disturbance, seizure, mental status change)
-High-risk comorbid condition (cancer, HIV)
-Last trimester of pregnancy
-New headache during pregnancy
-Headache associated w/ underlying pathology (secondary headache), except for minor sinus headache
-Symptoms constistent with migraine, but no formal diagnosis of migraine headache
-History of liver disease or consumption of more than 3 alcoholic drinks per day
Severe
What are some non-pharmacological treatments for headaches?
Chronic tension-type: _____ and
strengthen neck and head muscles
Migraine: regular sleep/ eat schedule,
stress reduction, _____to forehead
Nutritional strategies to prevent: restrict
foods that contain triggers, avoid hunger
and low blood glucose, add magnesium
supplement or zinc supplement
avoid foods with vasoactive substances:
nitrites, tyramine (__________and aged
cheese), phenylalanine (aspartame),
monosodium glutamate (MSG), ______,
___________(theobromines), any food
allergen
stretch, ice, red wine, caffeine, chocolate
What is the max dose of acetaminophen and what do you do if you suspect an overdose?
-1000mg (2 tabs) Q 6 hours=max __________tabs per day
-Watch combination products
-Check Rx medications
-Caps can be opened onto spoonful of food or drink
-Formulations are different
-AVOID USE IN people who have __or more drinks a day
-Suppository form available- 50-60% bioavailable
-_____________potential DI
max dose is 6 tabs per day for acetaminophen, avoid acetaminophen in people who drink 3 or more drinks a day
warfarin
What are the counseling points of NSAIDs?
May be taken with _________,milk, antacids,
Shake suspensions
Dont __ or _________ER versions
Other side effects: dizziness,fatigue, HA,nervousness
GI bleeds:rare but they do absolutely happen
-_________
-ASA and aspirin: take aspirin 1 hour before or 8 hours after ibuprofen
Food, DONT crush or chew NSAIDS, Don’t use NSAIDs on someone on warfarin
Explain the risk of NSAIDs in people with CVD? How do we educate people who have CVD who are asking to take an NSAID?
NSAIDS may cause an icnrease risk of serious cardiovascular thrombotic events. This may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at a greater risk.
___________and ________are contradicated for treatment of perioperate pain in the setting of coronary artery bypass graft (CABG)
ibuprofen and naproxen
What is Reye Syndrome? As a pharmacist, what do we need to know, ask and counsel about regarding Reye’s?
A Reye’s syndrome is a rare disorder occuring in childhood characterized by symptoms of encephalities combined with evidence of liver failure. Avoid use of________ in less than 19 years old
aspirin
What are the counseling points of salicyclate aka aspirin?
-GI symptoms
-Take with _______
-Avoid alcohol
-Avoid in pts with risk factors for GI bleeding
-Stop aspirin _______ days before surgery
food,STOP aspirin 2 to 7 days before surgery
With regards to pregnancy, what agent is recommended and NOT recommended to be used?
NSAIDs contraindicated in third trimester. DON’T use Ibuprofen and Naproxen in third trimester of pregnant women
AVOID aspirin
If breastfeeding, what analgesic is/are safe to use?
____________,______________,_______________
acetaminophen,ibuprofen, naproxen are safe to use in breastfeeding women
AVOID aspirin in breastfeeding women
Explain what RICE is and what is it used for?
RICE stands for rest,ice,compression, and elevation. It is used for MSK disorders
