OTC analgesicseffective 2 3times per week may cause medication overuse HAo

Otc analgesicseffective 2 3times per week may cause

This preview shows page 4 - 5 out of 5 pages.

OTC analgesics—effective, >2-3times per week may cause medication-overuse HA o Combination medication: Butalbital w/ ASA or APAP Isometheptene w/ APAP Dichloralphenazone Preventive Therapy: more than 1-2 episodes/week o BBs o TCAs Nonpharmacological therapy: heat or cold pack, message, acupuncture, stress management, biofeedback, workout Chronic Daily Headaches : HA >15 days/m lasting 3 mo Chronic migraine: 70-80% of reduction in attacks with DHE w/ antiemetics (5 mg metoclopramide or 10 mg prochlorperazine) o Preventive therapy: Inderal, Valporates, Amitriptyline, Topamax Hemicrania continua: responding completely to indomethacin & referral to neurologist Cluster HA : Intense pain lasting 15 min- 2hr occurring in clusters of several weeks or months at the same time of day, mostly night time; pain behind or around on eye w/ tearing, conjunctival injection, drooping of eyelid, nasal congestion, facial flushing, sweating; unable to lie or sit but pacing the floor Acute Therapy o Oxygen therapy 100% nonrebreather mask for 15-30 min o Sumatriptan or Zolmitriptan SC or intranasal o Intranasal lidocaine o Ergotamine Preventive Therapy o Verapamil o Divalproex o Lithium Medication-overuse headache : daily use of analgesics, combination medications (butalbital, or ergotamine, triptan)
Image of page 4
o HA >15 days/mo o Regular overuse for > 3mo o Worsened HA during therapy o HA resolves or revert to previous pattern within 2mo after discontinuation High potential if overuse of simple analgesics either along or combination Preventive therapy can be started when withdrawal process starts or 2-3 wks before or after withdrawal process o Withdrawal from simple analgesics: 550mg of Naproxen twice daily for 2-3wk or twice/d and then daily/wk o Withdrawal from Fioricet: Midrin plus clonazepam (Klonopin) for 1 wk and then taper or phenobarbital for 1wk plus promethazine (Phenergan) for 1-2wk for patients who used less than 8 pills per day Serous withdrawal Sx: delirium, Sz More than 8 pills per day needs to be managed in inpatient detoxification
Image of page 5

You've reached the end of your free preview.

Want to read all 5 pages?

  • Spring '14
  • Henrikson,J
  • migraine, Ergotamine

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern

Ask Expert Tutors You can ask You can ask ( soon) You can ask (will expire )
Answers in as fast as 15 minutes