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Flashcards in headache 6 Deck (20)
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1

what is the best way to achieve trigger avoidance for headaches

keep a headache diary

2

when should a triptan be taken for acute therapy of migraine with aura

when the headache starts; not during aura (causes more constriction)

3

what patient educated is needed for preventative migraine therapies

1. take daily
2. may take up to 6 months to see full effect
3. breakthrough headaches don't mean failure

4

what is status migrainosus

headache lasting longer than 72 hours (up to 1 week)

5

If someone comes to ER with status migrainosus and has been on tripan or DHE at home should be started on what?

IV valproic acid

6

what is always premedicated with reglan

IV DHE

7

what are two new drugs that target CGRP

olcegepant and telcegepant

8

what is the benefit of targeting CGRP

no vasoconstriction

9

what are the most common medications that cause medication overuse headaches

narcotic use
butalbital

10

what is the term for tension headaches experienced less than once per month

episodic

11

what characterizes a tension headache

1. bilateral
2. tightening/ pressing (non-pulsating)
3. not aggrevated by physical activity
4. no nausea or vomiting
5. not experiencing both photophobia and phonophobia

12

what has the most evidence in the prevention of tension headaches

1. TCA's (best)
2. topiramate
3. gabapentin

13

what are the characteristics of a cluster headache

1. very severe
2. unilateral
3. orbital
4. supraorbital
5. temporal

14

what are the symptoms of cluster headaches

1. nasal congestion
2. eyelid edema
3. facial sweating
4. red eyes/ tearing
5. restlessness or agitation

15

what is abortive therapy for managing a cluster headache attack

1. 12 L of oxygen for 15-30 minutes
2. ergotamine - fastest
3. triptan - SQ or nasal

16

what is the prophylactic treatment for cluster headaches

1. verapamil in high doses
2. lithium (always for cluster headaches only)

17

what is the best prophylxis for nocturnal cluster headaches

1. ergotamine
2. corticosteroids

18

what should be monitored when keeping a headache diary

1. frequency
2. intensity
3. duration
4. change in pattern

19

If headache starts with a loud clap, what would you recommend

go to emergency room ( or if worst headache of life)

20

If someone has a tension headache but once something stronger than ibuprofen what would you recommend

go see doctor for prophylaxis treatment