Wk 27 - CNS OTC (headache) Flashcards
What occurs during the prodromal phase of migraines?
- Mood variation
- Yawning
- Food cravings
- Fluid retention
What are the aura symptoms of a migraine?
- <1hr
- Flashing lights
- Blind spot
- Numbness + tingling
What are the symptoms during a migraine attack?
- Severe headache
- Throbbing
- Unilateral
- N+V
- Photo + phonophobia
What are the post dromal symptoms of migraines?
- Hangover effect
- Fatigue
- Depressed mood
Which conditions are migraines associated with an increased risk of?
- Depression
- Bipolar
- Anxiety
- Panic
What is first line for a migraine?
Paracetamol
Which anti-emetics can be used for migraines causing gastric stasis?
- Buclizine
- Prochlorperazine: blocks chemoreceptor trigger zone
How does sumatriptan work when treating migraines?
- Constrict blood vessels dilated during attack
- Alleviates headache, photophobia, phonophobia + nausea
What are the supply criteria for sumatriptan?
- Migraine diagnosed
- Analgesics ineffective
- 18-65
- Migraine for at least a year
- 5/more attacks
What are the precautions when using sumaptriptan?
- SSRi/SNRI
- St john’s wort
- COC
- 3/more HD risk factors: diabetes, high cholesterol, smoking, NRT
What are the CI of sumatriptan?
- Under 18, over 65
- Pregnant/breastfeeding
- CV risk/HPT
- Epilepsy
- MAOIs last 2 wks
- Triptan allergy
What are the counselling points for sumatriptan?
- 1 tab ASAP first sign
- Symptoms return + relief: 2nd after 2 hrs
- Max 2 in 24 hrs
What are the counselling points for migraines?
- Avoid trigger
- Immediate analgesic
- Sleep
- Dark + quiet env
- Hot/cold compress
What are the causes of tension headache?
- Posture
- Stress
- Anxiety
- Prolonged conc
- Fatigue
What are the symptoms of tension headache?
- Dull pain
- Tight band round head
- Dizzy
- Fatigue
- Sweating
How would you counsel a patient with tension headache?
- Identify cause
- Stress management
- Exercise
- Massage
What are the symptoms of cluster headaches?
- Severe boring in eye
- Men in 30s/40s
- Unilateral
- Blocked nostril
- Hot reddened cheek
- 15mins - 3 hrs
- Refer
What are the symptoms of temporal arteritis?
- Severe pain in temples
- Red prominent temporal artery
- Jaw pain
- Partial/complete vision loss
- Refer
What are the symptoms of trigeminal neuralgia?
- Unilateral
- Sudden + severe shooting pain
- 2 mins
- Several per day
- Painful touch
- Treated w/ carbamazepine/pregabalin
What are the symptoms of chronic daily headache?
- > 4hrs >15 days per month
- Analgesic/opioid/caffeine dependent
- Restrict opioid to 3 days
What are the symptoms of sinusitis?
- Symptomatic inflammation of paranasal sinuses
- Triggered by viral
- Pressure build up
- Unilateral, central, behind/btw eyes
- Worse bending forward/lying down
How do you treat sinusitis?
- Pain killers
- Decongestants
- Saline nasal wash/drops
What are the red flags for headaches?
- Migraine w/ COC
- Treatment failure
- Severe headache >4hrs
- ADR
- Stiff neck, visual disturbance
- Injury/trauma
- <12 yrs old
