Week 2: Headache Flashcards
What are 5 non-pharmacologic ways to treat migraines?
- regular sleeping and eating schedule
- avoid triggers (food, stress)
- cold packs and pressure
- rest in dark and quiet room
- keep a headache journal to find out triggering factors
A few exclusions for self-treatment include people with ____.
- severe head pain “this is the worst headache of my life”
- high fever or signs of serious infection
- secondary headache
What are some complimentary and alternative therapies (CAM) used for PREVENTION and TREATMENT of migraines?
- Feverfew: increases the risk of bleeding with warfarin
3. Magnesium: Diarrhea
What are some complimentary and alternative therapies (CAM) used for prevention of migraines?
- Butterbur
- Coenzyme Q10
- Riboflavin (vitamin B2)
A primary headache makes up for 90% of headaches and is not associated with any underlying illness.
What are examples of primary headaches?
- medication overuse headache
- cluster headache
- episode or chronic tension headache
- migraine headache
A secondary headache are symptoms of an underlying condition. What are examples that cause these secondary headaches?
- head trauma
- substance abuse withdrawal
- bacterial or viral illness
- meningitis
Can you self treat a secondary headache?
No - must refer the patient to PCP (primary care provider)
Can you self treat all primary headaches?
All - except for cluster and chronic tension headache
Exclusions for self-treatment include headaches persisting for ____.
10 days (with or without treatment)
Exclusions for self-treatment include the _____ of pregnancy.
last trimester
Exclusions for self-treatment include those who are ____ years of age.
less than 8
Exclusions for self-treatment include those with symptoms consistent with migraine but no ____.
formal diagnosis of migraine headache
_____ are 2 important medications associated with medication overuse headaches.
- acetaminophen (APAP)
2. Opioids (Vicodin, Norco, Dilaudid)
Non-Rx analgesics for headache should be limited to ____ to prevent medication overuse headache.
3 days/week
A tension headache is known as a “stress headache” and is the most common type of headache. It is a gradual onset and may last days. One of the types is an ___ in which a patient may self treat.
episodic
A tension headache is known as a “stress headache” and is the most common type of headache. It is a gradual onset and may last days. One of the types is an ___ in which a patient must be referred.
chronic
A chronic headache is one that could be consecutive or non-consecutive for more than ____.
15 days per month for at least 6 months
A ____ headache is a bilateral diffuse pain, often over the top of the head and extending to the rear and base of the skull. It can be triggered by stress, anxiety, depression, emotional conflicts, and repressed hostility.
tension
What are 4 pharmacological ways to treat tension headache?
- acetaminophen (Tylenol)
- ibuprofen (Advil, Motrin)
- naproxen sodium (Aleve)
- Excedrin Tension Headache (contains APAP and caffeine)
In ___ headaches, incidences are 3 times higher in women.
migraine
The symptoms of ___ headache are recurrent, UNILATERAL throbbing, with or without aura.
migraine
In migraine headaches, the symptoms BEFORE onset of the headache is called ____. These include shimmering or flashing areas or blind spots, difficulty speaking, muscle weakness, and visual and auditory hallucinations.
aura
What are 3 things that migraine headaches may be associated with?
- nausea/vomiting
- photophobia (fear of light)
- phonophobia (fear of sound)
___ headaches can be triggered by stress, oversleeping, magnesium deficiency, missing a meal, alcohol, menses, and hormone changes.
migraine
A pharmacologic treatment of migraine is ONLY for patients who have _____.
been diagnosed with migraine by a physician
For menstrual migraines, a pharmacologic treatment would be to start ______.
NSAIDs at least 2 days BEFORE the start of menses.
A pharmacologic treatment of migraine includes non-Rx analgesics and is MOST effective if taken at the _____.
onset of symptoms
It is helpful if the patient can predict the onset
Why should a patient only take 2 tabs in 24 hours when the ibuprofen max is 1200 mg/day or acetaminophen max is 4000 mg/day?
The manufacturer does NOT want you to continue to self-treat if it does not work.
You may need a prescription drug in order to treat your migraine symptoms.
A ____ headache is localized to the forehead and periorbital area. A patient may also experience toothache in the upper teeth, nasal stuffiness, and nasal discharge. It is intensified upon awakening, by blowing nose, and by stooping.
sinus
What is one of the ANALGESIC + DECONGESTANT treatments of sinus headache?
Advil Cold and Sinus
Ibuprofen 200 mg + Pseudoephedrine 30 mg
What is one of the analgesic + decongestant + expectorant treatments of sinus headache?
Tylenol Sinus Severe Congestion Daytime
APAP 325 mg + Pseudoephedrine 30 mg + guaifenesin 200 mg
What are two SALINE RINSE treatments of sinus headache?
Neilmed Sinus Rinse
Ocean Spray
A ___ headache includes pain usually behind the forehead and/or cheekbones.
sinus
A ___ headache includes pain in and around one eye.
cluster
A ___ headache includes pain like a band squeezing the head
tension
A ___ headache includes pain, nausea, and visual changes.
migraine
