Types of Headaches
A 30 year old woman presents to the office with complaints of severe head ache featuring nausea and vomitting after the onset for menstruation. What is the most likely diagnosis based off of this information?
Migraine Headache
A 30 year old woman presents with a Mild Acute Migraine. What is the first line pharmacologic therapy for this type of headache?
Serotonin Receptor Agonists (Triptans)
What is the mainstay of therapy for Tension Headaches?
Simple Analgesics (Acetaminophen) and NSAIDs (Aspirin, Ibuprofen, Naproxen Sodium, and Diclofenac)
What is one of the most common causes of headache?
Overuse of acetaminophen or ibuprofen
What two antidepressant drugs have shown to be most effective in the prophylaxis of migraine head aches in trials?
Amitriptyline and Venlafaxine
This type of headache is the most severe form of acute headaches.
Cluster Headache
This drug type should not be used in the treatment of Migraine Headaches because of addiction and rebound headaches.
Opiate Analgesics
These drugs are most commonly used for the prophylactic treatment of tension headaches
Tricyclic Antidepressants (a.k.a. amitriptyline)
This drug is used in repeat dosing over 3-7 days in order to break the cycle of frequent cluster headache attacks.
Dihydroergotamine IV
What is the most extensively utilized anticonvulsant for prophylaxis of migraine headaches?
Topiramate
MC type of primary headache
Tension Headache
What three classes of drugs can be used for prophylaxis of Migraine Headaches?
Beta-Blockers, Antidepressants, and Anticonvulsants
Number one abortive therapy of Cluster Headaches
Oxygen 100% via non-rebreather x 15-30 minutes
Non-Pharmacologic Therapy for Tension Headaches
CBT (stress management)
This class of drug is used as an adjunctive therapy to treat nausea/vomitting associated with migraine headaches
Anti-emetics
Middle aged man come is seen at the office with a complaint of painful headaches which strike most commonly at night. What type of headache is this?
Cluster Headaches
What drugs are appropriate for initial treatment in mild-moderate migraines prior to the use of Triptans?
Analgesics (Acetaminophen) and NSAIDs (Aspirin, Ibuprofen, Naproxen Sodium, and Diclofenac)
This drug is also used first line for cluster headaches along with the number one abortive therapy.
Triptans (6mg SQ Sumatriptan)
These drugs can be used for prophylactic therapy in Cluster Headaches, but are not as effective as the other two choices.
Corticosteroids (Prednisone 60mg/day tapered over 3 weeks)
What drug can be used as an alternative (or in conjunction with) Verapamil in the preventative treatment of cluster headaches?
Lithium (300mg BID)
This type of headache is bilateral and non-pulsatile.
Tension Headache
What is the most widely used drug class for migraine prophylaxis?
Beta-Blockers
Preferred first line treatment in the prevention of Cluster Headaches.
Verapamil
Freebie
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Which drug is used in the treatment of severe migraine attacks and contains caffeine to enhance absorption and potentiate analgesia?
Dihydroergotamine and Ergotamine