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Block 10
Tension Headache
Presentation
More Common in Women
Bilateral Band-like Pain
Occipital and Neck region
Exacerbated by Stress
Exacerbated by Fatigue
Duration
> 30 Minutes
Acute Treatment
Relaxation
Caffeine
NSAIDs
Acetaminophen
Preventative Treatment
Amitriptyline
1 min
Cluster Headache
Presentation
More Common in Men
Unilateral Periorbital Headache
Ipsilateral Tearing
Precipitated by Alcohol
Stabbing Pain
Duration
15 min - 3 Hours
Repetitive Attacks in Clusters
Treatment
High Flow 100% O2
Ergots
Sumatriptan
2 mins
Migraine Headaches Signs and Symptoms
Signs and Symptoms
More Common in Women
Exacerbated by Activity
Unilateral Pulsating Pain
Aura
Photophobia and Phonophobia
Nausea/Vomiting
Duration
4 hours to 3 Days
1 min
Migraine Headache Treatments
Acute Treatment
Avoid Triggers
Sumatriptan
NSAIDs
Preventative Treatment
Beta Blockers
Calcium Channel Blockers
Amitriptyline
Topiramate (Anticonvulsants)
1 min
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly Inhibits COX
Acts Primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
51 secs
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
1 min
Aspirin
Indications
Fever
Pain and Headache
Cardiovascular Disease (CAD)
Mechanism of Action
Irreversible inhibition of COX-1 and COX-2
Suppress Thromboxanes and Prostaglandins
NSAID
Side Effects
Reye's Syndrome
Tinnitus
Peptic Ulceration
Mixed Acidosis/Alkalosis
Nephropathy
2 mins
Aspirin Poisoning (Salicylism) Assessment
Early Symptoms
Nausea and Vomiting
Tinnitus
Confusion
Hyperventilation
Respiratory Alkalosis
Late Symptoms
Metabolic Acidosis
Coma
Hyperthermia
1 min
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
2 mins
Celecoxib
Indications
Rheumatoid Arthritis
Osteoarthritis
Pain
Mechanism of Action
NSAID
Selectively Inhibits COX-2
Side Effects
Sulfa Allergy
Increased Risk of Thrombosis
GI Bleed
Contraindication
Pregnancy > 30 Weeks
1 min
Methylergonovine (Methergine) and Ergotamine (Ergot Alkaloids)
Mechanism
Smooth Muscle Contraction
Vasoconstriction
Indications
Migraine
Postpartum Hemorrhage
Side Effects
Nausea and Vomiting
Severe Hypertension
Tachycardia
Considerations
2nd Line Agent
2 mins
Sumatriptan
Mechanism of Action
Short Half-Life
5-HT Agonist
Inhibits Trigeminal Nerve Activation
Induces Vasoconstriction
Indications
Migraine
Cluster Headache
Side Effects
Increased Risk of Serotonin Syndrome
Paresthesias
Coronary Vasospasm
Contraindication
Prinzmetal's Angina
Coronary Artery Disease (CAD)
3 mins
Butorphanol
Indications
Migraine
Severe Pain
Labor
Mechanism of Action
Partial Agonist at Mu and Full Agonist at Kappa Receptors
Less Respiratory Depression
Side Effects
Withdrawal Symptoms
1 min
Tramadol
Indications
Chronic Pain
Mechanism of Action
Weak Opioid
Inhibit Serotonin and NE reuptake
Side Effect
Increased Risk of Seizure
48 secs
Antipsychotics Overview
Generations
Typical
Atypical
Mechanism
Blocks D2 Receptor
2nd Generation Blocks the 5-HT 2 Receptor
Indications
Psychosis
Delirium
Bipolar Disorder
Tourette’s Syndrome
Side Effects
Hyperprolactinemia
Extrapyramidal Symptoms
Tardive Dyskinesia
Neuroleptic Malignant Syndrome
4 mins
High Potency Antipsychotic Drugs
High Potency Drugs
Fluphenazine
Trifluoperazine
Haloperidol
Pimozide
Side Effects
Extrapyramidal Symptoms
Short Term
Dystonia
Restlessness (Akathisia)
Torticollis
Long Term
Tardive Dyskinesia
Parkinson's-Like Symptoms
Neuroleptic Malignant Syndrome
3 mins
Haloperidol (Haldol)
Mechanism
High Potency Antipsychotic
Indications
Migraine
Schizophrenia
Side Effects
Extrapyramidal Symptoms
Weight Gain
QT Prolongation
Restlessness
Considerations
Caution in Seizure Patients
Neuroleptic Malignant Syndrome
2 mins
Low Potency Antipsychotic Drugs
Drugs
Chlorpromazine
Corneal Deposits
Thioridazine
Retinal Deposits
Shared Side Effects
Alpha1 Antagonist Effects
Anticholinergic Effects
Antihistamine Effects
2 mins
Chlorpromazine (Thorazine)
Mechanism
Low Potency Antipsychotic
Indications
Schizophrenia
Hiccups
Side Effects
Sedation
Weight Gain
Orthostatic Hypotension
Anticholinergic Effects
QT Prolongation
Neuroendocrine Effects
Caution in Seizure Patients
Corneal Deposits
2 mins
Neuroleptic Malignant Syndrome
FEVER Acronym
Fever
Encephalopathy
Vital Signs Unstable
Elevated Enzymes
Rigidity of muscles
Reversal Agent
D2 Agonists
Bromocriptine
Dantrolene
2 mins
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