Download to read offline
More Related Content
Similar to Headache theapeutics pharm d students.pptx
Headache theapeutics pharm d students.pptx
- 1. HEADACHE Submitted to- Dr.Sreelakshmi Nair Assistant professor Submitted by - Kritika Sehrawat Diksha Samyani Albina Abraham Simran Luthra Vaibhav Sharma Doctor of Pharmacy 4th year
- 2. What is Headache? •A headache is a painful and disabling feature of primary headache disorders. • Headaches are one of the top reasons people visit doctors or emergency rooms, making up more than 1% of visits. • As one of the top 10 presenting complaints in ambulatory medical care • The most common of the primary headache disorders, occurs during the most productive years of life (20 to 55 years of age)
- 3. Secondary Headache (Symptomatic oforganic disease) • Sinus Headache Primary Headache • Tension- type headache • Migraine • Cluster Headache Types of Headache Tension- type headache 1 Migraine 2 3 Sinus Headache 4 Cluster Headache
- 4. CLUSTER HEADACHE • Clusterheadache, the most severe of the primary headache disorders • It is characterized by attacks of severe, unilateral head pain • Cluster headache occur in series lasting for weeks or months (i.e., cluster periods) with 1-2 headache per day during the cluster • Cluster headaches can be episodic or chronic. • Men are more likely than women to have cluster headache, and onset generally occurs in those older than 20 years of age.
- 5.
- 6. • Severe Pain:The hallmark of cluster headaches is their severe, stabbing pain (worst pain) • Unilateral Pain: one-sided pain and concentrated around the eye. • Tearing and Redness: Affected eye may tear excessively, become red, and droop. • Nasal Congestion: Blocked or runny nose on the same side as the headache. • Restlessness and agitation are common during an episode. CLINICAL MANIFESTATION
- 8. Migraine is afamilial disorder characterized by recurrent attacks of headache widely variable in intensity, frequency, and duration. Attacks are commonly unilateral and usually associated with nausea, anorexia and vomiting. MIGRAINE
- 9. Etiology 1. Causes arenot fully understood 2. may be hereditary 3.pre-existing condition like depression or epilepsy Risk Factors 1. Stress and anxiety 2.sleep disruption 3.Hormonal changes 4.Skipped meals 5.Dehydration 6. Bright lights and loud noise Migraines attack tend to be recurrent and each attack last upto 3 days.
- 10. Types of Migraine 1.Migrainewithout Aura(most common)- >5 attacks lasting for 4-72 hours. a. Nausea, vomiting, photophobia, phono phobia b. > 2 of following unilateral > pulsating> aggravated by routine activity. 2. Migraine with Aura- >2 attacks with a. Aura(visual, sensory) b. Unilateral progression of symptoms over >5 minutes but <60minutes. c. Headache within 60minutes of aura.
- 13.
- 14. DIAGNOSIS • Clinical evaluations(based on symptoms, normal physical examination, neurological examination) • Red flag findings, that suggest an alternate diagnosis include- pain that reaches peak intensity with in few seconds or less • Headaches that increase in intensity or frequency for weeks or longer. • History of cancer(brain metastasis) or an immunosuppressive disorder • fever, meningitis or altered mental status • papilledema
- 15. CLINICAL MANIFESTATION • Pain ineyes, face or neck • Headache can be acute, frequent or throbbing • sensitivity to light , distorted vision , seeing flashes of light • Irritability, nasal congestion or scalp tenderness
- 16. SEVERITY DRUG THERAPY MILDSimple analgesics/NSAIDs or combination (+/-antiemetics) MODERATE NSAIDs combinations/ergot alkaloids/sumatriptan(+antiemetic) SEVERE Ergot alkaloids/sumatriptan/rizatriptan (+antiemetic) +prophlaxis - 1. Propranolol/ beta-blockers 2. Amitriptyline/other tricyclic antidepressants 3. Flunarizine/other Ca2+ channel blockers 4. Valproate/Topiramate TREATMENT
- 17. NON- PHARMACOGICAL TREATMENT • Yoga andmeditation • Acupuncture • Neuromodulation therapy • using icepacks on forehead • Resting in dark , quiet place
- 18. • Tension typeheadache is the most common type of primary headache • It is usually of mild or moderate intensity. • It is more common in women in adulthood. • Tension type headche is subcategorize as: 1.Infrequent episodic 2.frequent episodic 3.chronic Tension Type Headache
- 19. Pathophysiolog y The pain ofepisodic tension headaches originate from myofascial factors and peripheral sensitization of nociceptors
- 20. 1.Premonitory symptoms andaura are absent with tension-type headache. 2.Bilateral Pain is most common pain pattern -headband 3.Mild photophobia-sensitivity to light phonophobia-Sensitivity to sound Clinical Manifestation
- 21. Treatment Non Pharmacological Therapy Pharmacological therapy Psychophysiologic Therapy Physical Therapy •Reassurance • Counselling • Stress Management • Biofeedback • electrical nerve • stimulation • Exercise • Massage • acupuncture Acute treatment First line-Simple analgesics and NSAIDs Second line -ASA+APAP+ caffeine ,butalbital containing products Limit acute treatment to 2 days per week Preventive treatment (chronic TTH) TCA are prescribed most often (Considered if headache frequency more than 2 per week and duration greater than 3-4 hrs )
- 22. SINUS HEADACHE A sinusheadache is a symptom of sinus infections (sinusitis). Sinus headaches make your face hurt. You may feel a constant, dull ache behind the eyes or in your cheekbones, forehead and the bridge of your nose. The pain gets worse when you move your head suddenly or you bend over. Typically, sinus headaches go away once a sinus infection runs its course.
- 23. SIGNS AND SYMPTOMS Nasal congestion Anuncomfortable pressure behind the forehead Weakened sense of smell Green or yellow nasal discharge Fever Pain getting worse while leaning forward Runny nose
- 24. What causes sinus headache? The sinuses are air-filled cavities situated around your eyes and on either side of your nose. These cavities play an important role in warming and moistening the air you breathe. Healthy sinuses allow mucus to drain and air to circulate throughout the nasal passages. Sinuses are prone to inflammation, known as sinusitis, which may lead to the common symptoms of pressure and pain. The most common cause of sinusitis is a viral infection, but both bacteria and fungi can be the culprits. Allergies can also cause sinus inflammation. Less often, sinus pain and pressure are triggered by exposure to secondhand smoke, perfume, or other inhaled chemicals. Structural issues, like nasal polyps or a deviated septum, can prevent the sinuses from draining properly and allow inflammation to take hold. Sudden changes in air pressure can also cause pain without inflammation.
- 25. decongestant antihistamines nasal steroid sprays Pharmacologicaltreatment pain killers antibiotics saline nasal sprays
- 26. • Drink plentyof water to keep mucus thin and loose. • Apply a warm compress to your face. • Inhale steam. Spend time in a hot shower, or boil water and inhale the steam from a pot. Even steam inhaled from hot tea or chicken soup can help. Aim to inhale steam three to four times a day. • A neti pot or another sinus rinsing system may provide relief. Always use distilled, purified, or boiled water that is allowed to cool. • Elevate your head while sleeping. If the pain is on one side, sleep on the pain-free side. • Use saline nasal sprays to loosen mucus and rinse the sinuses Non- pharmacological treatment
- 27.