Headache (Adult)

Question 1

Recite the Headache CPG

Answer 1

Question 2

Are there any care objectives for the headache CPG?

Answer 2

• Nil for this CPG

Question 3

What are the primary indications for Paracetamol?

Answer 3

Question 4

What are the contraindications for paracetamol?

Answer 4

Question 5

What are the precautions for Paracetamol?

Answer 5

Question 6

What are the side effects of paracetamol?

Answer 6

Question 7

What are the indications for Prochlorperazine?

Answer 7

Question 8

What are the contraindications for Prochlorperazine?

Answer 8

Question 9

What are the precautions for Prochlorperazine?

Answer 9

Question 10

What are the side effects of Prochlorperazine?

Answer 10

Question 11

What are the indications for fentanyl?

Answer 11

Question 12

What are the contraindications for fentanyl?

Answer 12

Question 13

What are the precautions for fentanyl?

Answer 13

Question 14

What are the side effects of fentanyl?

Answer 14

Question 15

Why do we use paracetamol in headache?

Answer 15

• Use: First-line treatment for mild to moderate headaches (e.g. tension-type headaches).
• Mechanism: Acts centrally to inhibit prostaglandin synthesis, which helps reduce pain and fever.
• Why: Safe, effective, and well-tolerated for general pain relief.

Question 16

Why do we use prochlorperazine in headache?

Answer 16

• Use: Often used for migraine headaches, especially when associated with nausea or vomiting.
• Mechanism: Dopamine (D2) receptor antagonist — primarily antiemetic but also has some anti-migraine properties.
• Why:
• Controls nausea and vomiting (common in migraines).
• May also relieve the migraine itself via central action on dopamine receptors.

Question 17

Why do we use fentanyl in headaches?

Answer 17

• Use: Reserved for severe, refractory headaches not relieved by standard therapy — sometimes used in emergency settings.
• Mechanism: Potent opioid analgesic, acts on mu-opioid receptors to block pain signals.
• Why:
• Used with caution due to high risk of dependence and side effects.
• Might be used in monitored settings like EDs if other treatments have failed.
  *

Question 18

Does the O2 therapy guideline apply to this presentation?

Answer 18

• Only in cluster headache
• Or if evidence of hypoxaemia

Question 19

What are 3 differential diagnoses for headache?

Answer 19

• Headache
• Migraine
• ICH
• Head injury

Question 20

Why is serotonin syndrome a contraindication for fentanyl?

Answer 20

• Fentanyl has serotonergic activity, meaning it can increase serotonin levels in the brain
• It can worsen the effects of serotonin syndrome

Question 21

What secondary surveys apply to headache?

Answer 21

• DOLOR
• AEIOUTIPS
• Formal neurological assessment

Question 22

Do any CWI’s apply to this presentation?

Answer 22

• PO medication administration
• IM
• IV
• MAD
• Preparing medication for administration

Question 23

What are the indications for PO medication administration?

Answer 23

Question 24

What are the contraindications for PO medication administration?

Answer 24

Question 25

What are the precautions for PO medication administration?

Answer 25

Question 26

What are the indications for IM administration

Answer 26

Question 27

What are the contraindications for IM administration

Answer 27

Question 28

What are the precations for IM administration

Answer 28

Question 29

What are the indications for IV insertion

Answer 29

Question 30

What are the contraindications for IV insertion

Answer 30

Question 31

What are the precautions for IV insertion

Answer 31

Question 32

What are the indications for medication administration

Answer 32

Question 33

What are the contraindications for medication administration

Answer 33

Question 34

What are the precautions for medication administration

Answer 34

Question 35

What are the indications of using a MAD device?

Answer 35

Question 36

What are the contraindications of using a MAD device?

Answer 36

Question 37

What are the precautions of using a MAD device?

Answer 37