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
