Week 1: Headache/Fever Flashcards
define meaning of nonprescription status
- may be used without medical supervision
- self diagnose, self-treat, self-manage
- low potential for abuse and misuse
- benefits outweigh risks
whats required on OTC labels?
- drug facts
- expiration date
- warnings
- uses
- ingredients
Make sure to ask pt appropriate questions to make proper recommendations. Ex. make sure they aren’t taking blood pressure medication when recommending an OTC which may raise BP
.
Use what patient-care process to determine appropriate OTC recommendation?
CAPIF
what do you collect?
S and O
what do you assess?
appropriateness of recommendation using pt health info
Steps to make a recommendation for a patient complaining about a headache:
- assess pt & pain, obtain medical & med history, ask about attempted treatments
- If pt falls under any of the exclusions for self-treatment give them a medical referral
IF THEY DON’T -> - if using pain meds for HAs more than 3x/wk decrease use over a few days. if HA persists see Dr
IF THEY DON’T -> - If pt has diagnosed migraines or symptoms typical of sinus or episodic tension-type HA recommend appropariate nonpharm/pharm therapy
-> if not, refer to Dr.
Tension-Type Headache Location: Feeling: Intensity: Onset: Duration: Aggrevators: Non-headache symptoms:
bilateral tightening, pressing, constricting mild-moderate gradual onset 30 min to 7 days stress, anxiety scalp tenderness, neck pain and muscle tension
Migraine Headache Location: Feeling: Intensity: Onset: Duration: Aggrevators: Non-headache symptoms:
usually unilateral throbbing, pulsating moderate-severe sudden onset 4-72 hrs physical activity, light, sound nausea, vomiting, aura
Sinus Headache Location: Feeling: Intensity: Onset: Duration: Aggrevators: Non-headache symptoms:
face, forehead, or periorbital area (eyebrow level)
pressure behind eyes or face, dull and bilateral pain
mild-severe
simultaneous with sinus symptoms
days (resolves with sinus symptoms
nasal congestion
nasal congestion, nasal discharge
what are the exclusions for self-treatment for a headache (when you should give pt a medical referral)
severe pain continuous, worsening HAs HA persists for 10 days w/ or w/o treatment under 8 y/o high fever/sign of infection neck stiffness last trimester of pregnancy new headache during pregnancy history of liver disease or has over 3 alcoholic drinks daily
clinical reasons to avoid recommending salicylates and NSAIDS:
asthma GI ulcers gout using anti-coagulant therapy/coagulation disorder HBP congestive heart failure (CHF) kidney disease
if pt under 12 y/o, what drug should you avoid?
naproxen
if pt under 18 y/o, what drug should you avoid?
salicylates
for children younger than 12:
what is the weight based dosing for ibuprofen?
dosing interval?
maximum daily dose?
5-10 mg/kg
q 6-8h
300mg per dose up to 4 doses, DNE 1200mg/day
max dose of ibuprofen for 6-11 months 12-17 lbs?
acetaminophen?
50mg
80mg
max dose of ibuprofen for 12-23 months 18-23 lbs?
acetaminophen?
75mg
120mg
max dose of ibuprofen for 2-3 years 24-35 lbs?
acetaminophen?
100mg
160mg
max dose of ibuprofen for 4-5 years 36-47 lbs?
acetaminophen?
150mg
240mg
max dose of ibuprofen for 6-8 years 48-59 lbs?
acetaminophen?
200mg
320mg
max dose of ibuprofen for 9-10 years 60-71 lbs?
acetaminophen?
250mg
400mg
max dose of ibuprofen for 11 years 72-95 lbs?
acetaminophen?
300mg
480mg
for children younger than 12:
what is the weight based dosing for acetaminophen?
dosing?
maximum daily dose?
10-15 mg/kg
q 4-6h
480mg per dose up to 5 doses, DNE 2400mg/day
adult maximum daily dose of acetaminophen IR?
325-1000mg q 4-6h, DNE 3000 mg
adult maximum daily dose of acetaminophen XR?
650-1300mg q8h, DNE 3000mg
adult maximum daily dose of ibuprofen?
200-400mg q 4-6h, DNE 1200mg
adult maximum daily dose of naproxen?
initial dose: 2 tablets within first hour
220mg q 8-12h, DNE 660mg
adult maximum daily dose of aspirin?
325-1000mg q 4-6h, DNE 4000mg
adult maximum daily dose of magnesium salicylate?
1160mg q6h, DNE 4640mg
why should you not mix acetaminophen with alcohol?
increased risk of hepatotoxicity
why should you not mix acetaminophen with warfarin?
inc risk of bleeding
why should you not mix aspirin and NSAIDs?
inc risk of bleeding
why should you not mix ibuprofen with aspirin?
dec antiplatelet effect of aspirin
Steps to make a recommendation for a patient complaining about a fever:
- ask if temp has been taken, take temp
- obtain symptom info, med history, allergy info
- If pt falls under any of the exclusions for self-treatment give them a medical referral
IF THEY DON’T -> - if temp over 100.1 recommend non-pharm/pharm therapies
IF UNDER 100.1 -> - is patient over the age of 2? if not and fever has been there over 24 hours contact De
- if patient over age of 2, if fever has not resolved after 3 days see Dr
what are the exclusions for self-treatment for a fever (when you should give pt a medical referral)
severe symptoms of infection child with spots/rash child refuses to drink fluids child who is very sleepy child with temp over 104 child with stiff neck
why should you not give salicylates to children under 18?
increases risk of reye’s syndrome
cluster headache: Location: Feeling: Intensity: Onset: Duration: Aggrevators: Non-headache symptoms:
unilateral clustering around eye burning, piercing, throbbing very intense 5 to 10 minutes usually 30-90 min cigarette smoke, alcohol, strong smells eye redness/watering, runny/congested nose, warm face, sweating, light sensitivity
