Headaches

Question 1

Define headaches

describe area of most common form

Answer 1

• Most common form described as around base of skull and upper part of neck and sometimes pain extends up to the top of the head and above the eyes
• the suboccipital muscles can feel tender to touch
• pain feels like a band around the head

Question 2

Triggers for headaches

Answer 2

Diet
medication
stress
anxiety 
bad posture
tiredness
eyestrain 
Frequent use of painkillers

Question 3

Treatment timescale for headaches

Answer 3

with treatment should resolve within 1 day

Question 4

Symptoms of headaches

Answer 4

• Cluster headaches: uncommon and may occur suddenly. Happens in clusters of 2-3 weeks
• each daily episode of pain can last up to 3hrs
• severe pain in one side of head, usually around eye or temple
• dull pain

Question 5

referral criteria for headaches

Answer 5

• severe and >4hrs duration
• ADRs
• Children under 12yrs
• associated with head injury/trauma
• associated with drowsiness, unsteadiness, visual disturbances or vomiting
• location and type of pain (severe occipital across back of head and raised intracranial pressure) ,
• deep seated pain, severe and aggravated by lying down
• worse in morning that improves later on in the day
• nausea and vomiting
• neck stiffness
• frequent migraines or persistent headaches
• any woman taking the COC should be referred
• elderly upon fall

Question 6

Lifestyle advice for headaches

Answer 6

reduce stress
keep hydrated
rest
eye test

Question 7

3 main OTC treatments for headaches

Answer 7

paracetamol
ibuprofen
co-codamol

Question 8

Paracetamol for headaches
Pain severity
Directions

Answer 8

Moderate pain
Adults, the elderly and >12yrs:
2 tablets every 4hours to a max of 8 tablets/24hrs
Children 6-12yrs:
0.5-1 tablet every 4 hours to a maximum of 4 tablets in 24 hours

Question 9

Paracetamol warnings and counselling

Answer 9

Caution with severe renal or hepatic impairment
Do not take with: anticoagulants, cholestyramine, metoclopramide, chlorampenicol
Do not take anything else containing paracetamol whilst taking this medicine a

Question 10

paracetamol patient populations

Answer 10

> 6yrs only

Fine for pregnancy and breastfeeding

Question 11

Headache

Ibuprofen symptoms and directions

Answer 11

For the relief of mild to moderate pain including migraine and headache
1-2 tables taken up to TDS, PRN with waater
Leave at least 4 hours between doses and do not take more than 1200mg (6 tablets) in any 24 hour period
12yrs: max 3 days
18yrs: ma 10 days

Question 12

Ibuprofen for headache
Warnings
Populations

Answer 12

do not take if you have: asthma, diabetes, high cholesterol, high blood pressure, had a stroke, heart, liver, kidney or bowel problem
>12 yrs only
Do not take in pregnancy or breastfeeding

Question 13

Co-codamol indication (headache)

Answer 13

Short term treatment of acute moderate pain which is not relieved by other analgesics (paracetamol, ibuprofen)

Question 14

Co-codamol directions

Answer 14

Adults: 1-2 capsules, if necessary, TDS/QDS of intervals of >4 hours
maximum 8 capsules in 24 hours

Children aged 16 to 18 years:
One to two tablets every 6 hours when necessary, up to a maximum of eight tablets in 24 hours.

Children aged 12 to 15 years:
One tablet every four hours when necessary, up to a maximum of four tablets in 24 hours.

Question 15

Co-codamol warnings and populations

Answer 15

Do not take if under 12yrs
Avoid if pregnant or breastfeeding
Can cause addiction