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  1. 1. Headache Headache is not a disease state or a condition. Classification of headache:- Headache classify into three types. Cluster headache Tension headache Migraine headache Headache may be symptomatic (primary headache) or asymptomatic (secondary headache). In community pharmacy the overwhelming majority of the patients (80-90%) will present with tension headache. 1*Tension headache:- Etiology: - The mechanisms that bring about headache are still poorly understood. Tension headaches commonly referred to as muscle contraction headache, as electromyography has shown potential muscle contraction, which is also exacerbated by stress. In tension headache the pain is bifrontal or bioccipital, generalized and non- throbbing the patient may describe the pain as tightness. Pain is normally mild to moderate and not aggravated by movement, although it is often worse under pressure or stress. The pain is gradual in onset and ten to worsen progressively through the day. Types:- Two types,(a) Acute tension headache: - It occurs when the patient experiences the head for less then15 days per month.(b) Chronic tension headache: - Head occur for more then 15 days per month and last for more then 6 month. 1
  2. 2. 2*Migraine headache: - Migraine has three phases, (i) Asymptomatic phase (phase 1) → show no symptoms. (ii) Prodromal phase (phase 2) →visual disturbance actual headache start. (iii) Headache phase (phase 3) →pain nausea and vomiting Migraine headache has basically two types. (a) Migraine with aura (b) Migraine without aura (a) Migraine with aura: - (classic migraine) This account for less then 25% patient of migraine cases. The aura develops 5 to 20 min and can last for up to 1hr. Symptoms:- Visual auras• Scotomas (blind spots)• Fortification spectra (zig-zag lines) or flashing and flickering light. Neurological auras• Pines and needles typically start in hand, migrating up to arm before jumping to the face and lips.• Nausea, vomiting• Photophobia• Phonophobia Nature of pain: -pain is unilateral, throbbing and moderate to sever. Some time the pain become generalized and diffuse. Physical activity may intensify the pain. (b)Migraine without aura: - (common migraine) 2
  3. 3. The remaining suffers 75 % do not experience an aura but do suffer from all other symptoms as describe above. 3*Cluster headache: - Cluster headache is predominant condition that affects the men aged b/w 40 and 60. typically the headache occur at the same time each day and last b/w 10min and 3 h, 50% patient experiencing night time symptoms. Patient are woke 2 to 3h after falling sleep with steady intense unilateral orbital, boring pain. It may be characterized by period of acute attack, lasting a number of weeks to a few months. Alcohol may trigger the attack. Symptoms:- • Conjunctivitis • Nasal congestion Drugs used for the treatment of migraine:- 1. Migraleve (paracetamol codeine) 2. Midrid (Isometheptene mucate) 3. Buccastem M (prochlorperazine)Medicine Use in Side Drug Patient in Pregnanc 3
  4. 4. children effects interactio whom care y n should be exercisedMigraleve >10years Dry ↑es Glaucoma , Avoid in mouth, sedation prostate third constipatiwith enlargement trimester on & alcohol, sedation opioid analgesics, anxiolytics, hypnotics and antidepress antMidrid >12years Dizziness Avoid with Hypertension Avoid , rash the MAOIs , diabetic , Beta- blockers & TCAsBuccastem >18 years Drowsine ↑es Patient with okM ss sedation Parkinsons with disease, alcohol, Epilepsy and opioid Glaucoma analgesics, anxiolytics, hypnotics and antidepress ant 4

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  • AAZ88

    Aug. 20, 2012


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