Pharamcotherapeutics- Headaches

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  1. When should you see a doctor for a headache?
    When chronic or >4hr/day and 15 days/month for >3 months for very severe headaches that may be caused by underlying disease state
  2. Should you be seeing a doctor for random acute headaches?
  3. What are the four types of headaches?
    Sinus, Cluster, Tension, Migraine
  4. Describe the location of pain for a Sinus headache:
    Pain behind forehead and/or cheekbones
  5. Describe the location of pain for a Cluster headache:
    Pain is in and around the eye
  6. Describe the location of pain for a Tension headache:
    Pain like a band squeezing the head
  7. Describe the location of pain for a Migraine headache:
    Often pain on just one side of the head
  8. What percent of the population gets migraine headaches?
  9. What percent of men get migraine headaches?
  10. What percent of women get migraine headaches?
  11. What is the definition of a Migraine Headache?
    Episodic and associated with severity, light/sound sensitivity and nausea
  12. What are the four stages of Migraine headaches?
    Prodrome, aura, headache and postdrome
  13. What is the most common type of Migraine?
    Without aura
  14. What percent of Migraine's are without aura?
  15. What percent of Migraine sufferers have prodrome?
  16. When is the onset of Prodrome?
    24-48 hours before the onset of the headache
  17. What are the symptoms of prodrome?
    Euphoria, epression, irritability, cravings, neck stiffness and yawning
  18. What percent of migraine patients experience aura?
  19. What are the symptoms of aura?
    Bright spot or area of visual loss, can have sensory, verbal or motor disturbance
  20. Describe the headache phase of Migraine:
    Often unilateral, trobbing, N/V, photophobia, phonophobia
  21. Describe the Postdrome phase of migraines:
    Sudden head movement causes pain in the area where the headache was, exhaustion
  22. What are the characteristics of Cluster Headaches?
    Severe attacks of orbital or temporal pain
  23. What is the lifetime prevalence of Cluster Headaches?
  24. Do men or women get cluster headaches more?
    Men (4.3:1)
  25. What is the relative duration of a cluster headache?
  26. What is the frequency of headaches for cluster headaches sufferers?
    Can occur up to 8 times a day
  27. Are cluster headaches unilateral, bilateral or both?
    Strictly unilateral
  28. Do patients with cluster headaches or migraines like to be moving during an attack?
    Cluster headaches
  29. What is the most prevalent headache?
  30. What are the characteristics of a tension headache?
    Mild to moderate, bilateral, non-throbbing "band-like"
  31. What are the three subtypes of Tension Headaches?
    Infrequent, Frequent and chronic
  32. Describe an infrequent Tension headache:
    <1 day/month
  33. Describe a frequent Tension headache:
    1-14 days/month
  34. Describe a chronic Tension headache:
  35. What is the basic treatment for all headache types?
    OTC analgesics (Aspirin, Acetaminophen, NSAIDS), maybe caffeine
  36. Are all Nutraceutical treatments different for all headache types?
  37. What Rx's are used for treatment of Headaches?
    NSAIDs, triptans,narcotics
  38. What preventative medications are used for treatment of headaches?
    Antidepressants, beta-blockers, anticonvulsants, muscle relaxers
  39. When are Rx's used instead of OTC products for headaches?
    When OTC is not effective
  40. Why would you recommend liquid gels over tablets for a headache?
    They work faster
  41. What pediatric products can be used for headaches?
    Ibuprofen and Acetaminophen
  42. What OTC products cannot be used for children with headaches?
    Naproxen and Aspirin
  43. What age group can used Ibuprofen for headaches?
    >6 months
  44. What age group can use acetaminophen for headaches?
    >2 years
  45. What is the recommended dose of Caffeine for headaches?
    250mg daily
  46. What is the proposed mechanism of caffeine treatment of headaches?
    Constricts blood vessels in the brain
  47. What is the limit for caffeine for the treatment of headaches in pregnant women?
  48. Is Caffeine usually administered alone of with other products for treatment of headaches?
    With aspirin, acetaminophen and NSAIDs
  49. Does Excedrine Migraine contain caffeine?
  50. Does Bayer migraine contain caffeine?
  51. What causes sinus headaches?
    Blockage or infection in nasal cavities
  52. What type of headache presents in the middle of the forehead and around the eyes?
    Sinus headache
  53. What othe type of headache is easily confused with a migraine?
    Sinus headache
  54. What is the treatment for a Sinus headache?
    Pseudoephedrine and analgesic
  55. What is the mechanism for Alcohol induced headaches?
    Alcohol is broken into acetaldehyde which causes headaches
  56. What OTC is not recommended for the treatment of alcohol induced headaches?
  57. Why is Acetaminophen not recommended for Alcohol induced headaches?
    Interactions in the liver
  58. What is the best cure for alcohol induced headaches?
    Water, vitamins and exercise
  59. What are the seven Nutraceuticals that were presented for treatment of headaches?
    Butterbur, Feverfew, Coenzyme Q-10, Riboflavin, magnesium, Capsicum, peppermint oil
  60. What is the NMCD rating for Butterbur in the treatment of Migraines?
    Possibly effective
  61. What is the binominal Latin name for Butterbur?
    Petasites hybridus root extract
  62. What is the possible mechanism of Butterbur headache treatments?
    Ca channel regulation influencing inflammation
  63. What is the appropriate dose for Migraine treatment with butterbur?
    50 mg 2 times a day
  64. How long does it take to see a benefit from butterbur?
    Up to 4 months
  65. Are there any studies showing safety and efficacy of Butterbur in migraine treatments?
    Yes, several
  66. What Is the Latin binomial name for Feverfew?
    Tanacetum parthenium
  67. What is the potential mechanism of action of Feverfew?
    Parthenolides in the leaves inhibit platelet aggregation and serotonin release from WBCs. Also an anti-inflammatory
  68. What is the dose for Feverfew?
    5-100mg daily
  69. What is the NMCD rating for Feverfew?
    Possibly effective for migraine frequency and severity
  70. What is the appropriate headache reduction dose of Feverfew for pregnant women?
    Non, should not be used (can cause uterine contractions)
  71. What group might Coenzyme Q10 be most effective in?
    Pediatric patients
  72. What is another name for Riboflavin?
    Vit. B2
  73. What is the role of B2 in the human body?
    Membrane stability and energy related cellular functions
  74. What is the dose for Riboflavin?
    400 mg daily
  75. What is the duration of use before a benefit is seen for Riboflavin?
    ~3 months
  76. What is the NMCD rating for Riboflavin headache treatments?
    Possibly effective for reducing the frequency of migraines
  77. What is the mechanism of action for Magnesium treatments for headache?
    Deficiency is associated with neurotransmitter releases, platelet aggregation, and vasoconstriction
  78. What is the NCMD rating for Magnesium prophylaxis for headaches?
    Possibly effective in reducing the frequency of cluster and migraine headaches
  79. What group is magnesium prophylaxis most effective in?
    Women with menstrual related migraines
  80. What is the route of administration for Capsicum?
    Intranasal spray
  81. What is the mechanism of action for capsicum?
    Inhibits substance P, decreases vasodilation, decreases histamine/serotonin, decreases plasma extravasation
  82. What is the NCMD rating for Capsicum?
    Possibly effective at reducing the frequency and severity of cluster headaches
  83. What is the time delay before Capsicum becomes effective?
    About a week
  84. What unpleasant side effect is associated with Capsicum?
    Burning sensation
  85. Is Capsicum commonly used?
  86. Is Capsicum easy to find?
  87. What is the mechanism of action for peppermint oil treatment for headaches?
    Not Clear, possibly more of a relaxant than a pain reliever
  88. What is the NCMD rating for Peppermint oil as a headache treatment?
    Possibly effective for tension headaches
  89. Is peppermint oil recommended for young children for headache tratments?
    No, possibly an irritant
  90. What are the directions of use for headache treatment with peppermint oil?
    Apply 10% peppermint oil in alcohol to temples and forehead every 15-30 minutes
  91. What is the main ingredient in Head On?
  92. What are non-drug therapies for headaches?
    Stress reduction, meditation, acupuncture, spinal manipulation, massage
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Pharamcotherapeutics- Headaches
Pharamcotherapeutics- Headaches
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