This document provides an overview of common medications used to treat migraines, including both preventative and rescue medications. It discusses lifestyle modifications that should be implemented alongside medications. For rescue medications, it emphasizes treating early in the migraine attack to improve effectiveness. Common over-the-counter options like NSAIDs, acetaminophen, and combination products are reviewed, alongside prescription medications including triptans, anti-nausea drugs, and opioids. The document cautions against medication overuse headache and stresses individualizing treatment based on a patient's needs and triggers.
Oleanz (Generic Olanzapine Tablets) is used for the treatment of schizophrenia. This medicine may also be used alone or with other medicines (eg, lithium or valproate) for the acute treatment of manic or mixed episodes associated with bipolar I disorder and maintenance treatment of bipolar I disorder. Olanzapine may also be used together with Fluoxetine to treat depression that is a part of bipolar disorder, and depression in patients who received other antidepressants that did not work well.
1. Carbamazepine is associated with all of the listed adverse effects except neurotoxicity.
2. Phenytoin follows zero order kinetics, is teratogenic, is not excreted unchanged in urine, and induces microsomal enzymes.
3. Gum hyperplasia is seen with phenytoin.
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Objectives
Identify the symptoms of marijuana intoxication
Review the research related to the short and long term effects of marijuana on the brain and body
Explore the medical uses of marijuana
Discuss marijuana as a gateway drug
What is It
Marijuana refers to the dried leaves, flowers, stems, and seeds from the hemp plant, Cannabis sativa.
The plant contains the mind-altering chemical delta-9-tetrahydrocannabinol (THC)
Extracts with high amounts of THC can also be made from the cannabis plant
How is it Used
Smoked
Joints
Pipes or water pipes (bongs)
Blunts—emptied cigars that have been partly or completely refilled with marijuana.
Vaporized
Pull the active ingredients from the marijuana and collect their vapor in a storage unit which is inhaled instead of smoke.
Eaten: Brownies, cookies, or candy, or brew it as a tea.
How is it Used
Resins: A newly popular method of use is smoking or eating different forms of THC-rich resins
Smoking THC-rich resins extracted from the marijuana plant is on the rise. Users call this practice dabbing. People are using various forms of these extracts, such as:
hash oil or honey oil—a gooey liquid
wax or budder—a soft solid with a texture like lip balm
shatter—a hard, amber-colored solid
Oral Ingestion
Orally consumed cannabinoids tends to be stronger and last longer (4-6 hours) than inhaled cannabis.
This is because of the way bodies metabolize THC.
When cannabis is inhaled, THC passes rapidly from the lungs to the blood stream and to the brain.
When cannabis is consumed orally, a significant portion of THC is converted into the metabolite 11-hydroxy-THC before reaching the brain.
This metabolite is believed to be slightly more potent than THC and possesses a greater blood-brain penetrability
Short Term Effects
THC effects are felt more slowly when the person eats or drinks it. (30 minutes to 1 hour)
Effects
Altered senses (for example, seeing brighter colors)
Temporary hallucinations
Altered sense of time
Changes in mood
Impaired body movement
Difficulty with thinking and problem-solving
Impaired memory
Breathing problems. Marijuana smoke irritates the lungs
Increased heart rate for up to 3 hours after smoking
In this presentation, I looked into caffeine’s effects on our health mentally, physically, and socially, and whether or not these effects are beneficial to our well-being. I also provided safe consumption and coffee alternatives.
Template from: Slidesgo
This document provides information on the management of migraines. It defines migraines and discusses their prevalence, burden, triggers, phases, and classification. It also covers the pathophysiology of migraines and outlines approaches to diagnosis, abortive treatment, and preventive treatment including medications like propranolol. Propranolol is positioned as the gold standard preventive treatment and its mechanisms of action, formulations, efficacy, dosage, and advantages over immediate-release versions are detailed.
Oleanz (Generic Olanzapine Tablets) is used for the treatment of schizophrenia. This medicine may also be used alone or with other medicines (eg, lithium or valproate) for the acute treatment of manic or mixed episodes associated with bipolar I disorder and maintenance treatment of bipolar I disorder. Olanzapine may also be used together with Fluoxetine to treat depression that is a part of bipolar disorder, and depression in patients who received other antidepressants that did not work well.
1. Carbamazepine is associated with all of the listed adverse effects except neurotoxicity.
2. Phenytoin follows zero order kinetics, is teratogenic, is not excreted unchanged in urine, and induces microsomal enzymes.
3. Gum hyperplasia is seen with phenytoin.
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Objectives
Identify the symptoms of marijuana intoxication
Review the research related to the short and long term effects of marijuana on the brain and body
Explore the medical uses of marijuana
Discuss marijuana as a gateway drug
What is It
Marijuana refers to the dried leaves, flowers, stems, and seeds from the hemp plant, Cannabis sativa.
The plant contains the mind-altering chemical delta-9-tetrahydrocannabinol (THC)
Extracts with high amounts of THC can also be made from the cannabis plant
How is it Used
Smoked
Joints
Pipes or water pipes (bongs)
Blunts—emptied cigars that have been partly or completely refilled with marijuana.
Vaporized
Pull the active ingredients from the marijuana and collect their vapor in a storage unit which is inhaled instead of smoke.
Eaten: Brownies, cookies, or candy, or brew it as a tea.
How is it Used
Resins: A newly popular method of use is smoking or eating different forms of THC-rich resins
Smoking THC-rich resins extracted from the marijuana plant is on the rise. Users call this practice dabbing. People are using various forms of these extracts, such as:
hash oil or honey oil—a gooey liquid
wax or budder—a soft solid with a texture like lip balm
shatter—a hard, amber-colored solid
Oral Ingestion
Orally consumed cannabinoids tends to be stronger and last longer (4-6 hours) than inhaled cannabis.
This is because of the way bodies metabolize THC.
When cannabis is inhaled, THC passes rapidly from the lungs to the blood stream and to the brain.
When cannabis is consumed orally, a significant portion of THC is converted into the metabolite 11-hydroxy-THC before reaching the brain.
This metabolite is believed to be slightly more potent than THC and possesses a greater blood-brain penetrability
Short Term Effects
THC effects are felt more slowly when the person eats or drinks it. (30 minutes to 1 hour)
Effects
Altered senses (for example, seeing brighter colors)
Temporary hallucinations
Altered sense of time
Changes in mood
Impaired body movement
Difficulty with thinking and problem-solving
Impaired memory
Breathing problems. Marijuana smoke irritates the lungs
Increased heart rate for up to 3 hours after smoking
In this presentation, I looked into caffeine’s effects on our health mentally, physically, and socially, and whether or not these effects are beneficial to our well-being. I also provided safe consumption and coffee alternatives.
Template from: Slidesgo
This document provides information on the management of migraines. It defines migraines and discusses their prevalence, burden, triggers, phases, and classification. It also covers the pathophysiology of migraines and outlines approaches to diagnosis, abortive treatment, and preventive treatment including medications like propranolol. Propranolol is positioned as the gold standard preventive treatment and its mechanisms of action, formulations, efficacy, dosage, and advantages over immediate-release versions are detailed.
Dokumen tersebut membahas tentang antibiotika dan kemoterapeutika. Ia menjelaskan definisi, jenis, mekanisme kerja, dan contoh dari berbagai antibiotika seperti penisilin, sefalosporin, makrolid, tetrasiklin, aminoglikosida, dan antituberkulosis. Dokumen tersebut juga membahas tentang resistensi bakteri, efek samping antibiotika, dan faktor-faktor penyebab kegagalan terapi antimikroba.
Voveran (Generic Diclofenac Sodium Tablets) is used for relief of the signs and symptoms of osteoarthritis, for relief of the signs and symptoms of rheumatoid arthritis and for acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
Terapi antidot bertujuan untuk membatasi efek toksik zat kimia atau menyembuhkannya. Terapi dapat berupa nonspesifik seperti menghambat absorpsi atau mempercepat eliminasi, atau spesifik seperti membentuk kelat, bekerja pada reseptor, atau menetralisir enzim. Pelaksanaannya bergantung pada jenis zat beracun dan sasaran terapinya.
Migraine is a common neurological disorder characterized by recurrent headaches. It has strong genetic components and is believed to involve a hyperexcitable brain and trigeminovascular system. The pathophysiology involves cortical spreading depression, activation of the trigeminal nerve, and neurovascular inflammation. Treatment involves identifying and avoiding triggers, acute medications like triptans, and preventive strategies. Management requires patient education and a collaborative approach.
This document provides information on various antihelmintic drugs used to treat helminth infections. It discusses the epidemiology of soil-transmitted helminth infections and mechanisms of action of different classes of antihelmintics. Key drugs discussed include mebendazole, albendazole, ivermectin, praziquantel, diethylcarbamazine, and piperazine. Each drug's indications, mechanisms of action, pharmacokinetics, clinical uses, and adverse effects are summarized.
Vancomycin is used to treat serious infections caused by gram-positive bacteria like Staphylococcus when other antibiotics cannot be used. It works best when maintained above the minimum inhibitory concentration for the target bacteria. Vancomycin should be administered intravenously in dilute solution at a slow rate to avoid infusion reactions and tissue damage from extravasation. Dosing is based on creatinine clearance and weight, with levels monitored regularly due to risks of toxicity, especially to the kidneys.
This document discusses antiemetic and antinausea drugs. It describes how these drugs work to relieve nausea and vomiting by blocking pathways in the brain that stimulate the vomiting reflex, such as the vomiting center and chemoreceptor trigger zone. The document outlines several classes of antiemetic drugs including anticholinergics, antihistamines, antidopaminergics, prokinetics, serotonin blockers, and tetrahydrocannabinoids. Each class is described in terms of its mechanism of action and examples of specific drugs used to prevent and reduce nausea and vomiting.
Chronic daily headache is a debilitating condition affecting millions in the US. It involves headaches occurring more than 15 days per month for over 3 months. The document discusses the diagnosis and management of chronic daily headache. Key points include distinguishing between primary headache disorders like migraine from secondary disorders caused by other conditions. Treatment involves identifying medication overuse, treating any comorbid conditions, using preventive medications, and limiting the use of rescue medications to no more than 2 times per week to prevent rebound headaches.
This document discusses the management of headaches through various approaches including home remedies, drug classifications, counseling, and preventive treatment. It outlines several home remedies for headaches like ginger, essential oils, and cold compresses. It describes classes of drugs used to treat headaches like NSAIDs, opioids, ergot alkaloids, triptans, and fixed dose combinations. The document provides counseling points for these drug classes and discusses considerations for migraine preventive therapy.
This document discusses the management of acute and chronic pain. It defines pain and describes it as a subjective experience that can be physical, psychological, emotional, or spiritual. The document then discusses the WHO analgesic ladder for treating mild, moderate, and severe pain with non-opioids, weak opioids like codeine, and strong opioids like morphine respectively. It also describes characterizing pain by duration, mechanism, origin, and situation.
Migraine is a severe headache accompanied by nausea, vomiting, light and sound sensitivity. It is caused by vasodilation of cranial blood vessels. Treatment includes acute medications like triptans and ergot alkaloids to constrict vessels and relieve symptoms. Prophylactic drugs like beta-blockers, antidepressants, and anticonvulsants are used to reduce migraine frequency. Triptans are the most effective acute treatment but can have cardiovascular side effects, while ergot alkaloids are less tolerated but more specific vasoconstrictors. Prophylaxis is recommended for those with frequent or severe migraines.
Migraine is a common neurological disorder characterized by severe headaches. Common triggers include diet, hormones, environment, and stress. Migraine attacks involve a headache phase with throbbing pain that worsens with activity along with symptoms like nausea and sensitivity to light/sound. Some people experience an aura phase before the headache with visual or sensory disturbances.
Treatment involves managing triggers, acute treatments like triptans to stop headaches, and preventive medications for those with frequent attacks. Preventive options include beta blockers, anti-seizure medications, and antidepressants, with the goal of reducing attack frequency and severity. Proper acute and preventive treatment along with lifestyle modifications can help manage migraine.
Migraine is a common type of headache characterized by severe throbbing pain, nausea, and sensitivity to light and sound. It is believed to be caused by swelling of blood vessels in the brain and is more common in women. Symptoms include headaches lasting 4-12 hours that may be preceded by visual disturbances. Treatment involves managing triggers to prevent headaches and using over-the-counter or prescription medications to stop headaches once they start or reduce their frequency. While migraines often continue for many years, symptoms typically lessen for most people after age 50-60.
Migraine and Tension Headache Diagnosis and Treatment Guideline, 1999–2013 Group Health Cooperative. , https://provider.ghc.org/all-sites/guidelines/headache.pdf
Dokumen tersebut membahas tentang antibiotika dan kemoterapeutika. Ia menjelaskan definisi, jenis, mekanisme kerja, dan contoh dari berbagai antibiotika seperti penisilin, sefalosporin, makrolid, tetrasiklin, aminoglikosida, dan antituberkulosis. Dokumen tersebut juga membahas tentang resistensi bakteri, efek samping antibiotika, dan faktor-faktor penyebab kegagalan terapi antimikroba.
Voveran (Generic Diclofenac Sodium Tablets) is used for relief of the signs and symptoms of osteoarthritis, for relief of the signs and symptoms of rheumatoid arthritis and for acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
Terapi antidot bertujuan untuk membatasi efek toksik zat kimia atau menyembuhkannya. Terapi dapat berupa nonspesifik seperti menghambat absorpsi atau mempercepat eliminasi, atau spesifik seperti membentuk kelat, bekerja pada reseptor, atau menetralisir enzim. Pelaksanaannya bergantung pada jenis zat beracun dan sasaran terapinya.
Migraine is a common neurological disorder characterized by recurrent headaches. It has strong genetic components and is believed to involve a hyperexcitable brain and trigeminovascular system. The pathophysiology involves cortical spreading depression, activation of the trigeminal nerve, and neurovascular inflammation. Treatment involves identifying and avoiding triggers, acute medications like triptans, and preventive strategies. Management requires patient education and a collaborative approach.
This document provides information on various antihelmintic drugs used to treat helminth infections. It discusses the epidemiology of soil-transmitted helminth infections and mechanisms of action of different classes of antihelmintics. Key drugs discussed include mebendazole, albendazole, ivermectin, praziquantel, diethylcarbamazine, and piperazine. Each drug's indications, mechanisms of action, pharmacokinetics, clinical uses, and adverse effects are summarized.
Vancomycin is used to treat serious infections caused by gram-positive bacteria like Staphylococcus when other antibiotics cannot be used. It works best when maintained above the minimum inhibitory concentration for the target bacteria. Vancomycin should be administered intravenously in dilute solution at a slow rate to avoid infusion reactions and tissue damage from extravasation. Dosing is based on creatinine clearance and weight, with levels monitored regularly due to risks of toxicity, especially to the kidneys.
This document discusses antiemetic and antinausea drugs. It describes how these drugs work to relieve nausea and vomiting by blocking pathways in the brain that stimulate the vomiting reflex, such as the vomiting center and chemoreceptor trigger zone. The document outlines several classes of antiemetic drugs including anticholinergics, antihistamines, antidopaminergics, prokinetics, serotonin blockers, and tetrahydrocannabinoids. Each class is described in terms of its mechanism of action and examples of specific drugs used to prevent and reduce nausea and vomiting.
Chronic daily headache is a debilitating condition affecting millions in the US. It involves headaches occurring more than 15 days per month for over 3 months. The document discusses the diagnosis and management of chronic daily headache. Key points include distinguishing between primary headache disorders like migraine from secondary disorders caused by other conditions. Treatment involves identifying medication overuse, treating any comorbid conditions, using preventive medications, and limiting the use of rescue medications to no more than 2 times per week to prevent rebound headaches.
This document discusses the management of headaches through various approaches including home remedies, drug classifications, counseling, and preventive treatment. It outlines several home remedies for headaches like ginger, essential oils, and cold compresses. It describes classes of drugs used to treat headaches like NSAIDs, opioids, ergot alkaloids, triptans, and fixed dose combinations. The document provides counseling points for these drug classes and discusses considerations for migraine preventive therapy.
This document discusses the management of acute and chronic pain. It defines pain and describes it as a subjective experience that can be physical, psychological, emotional, or spiritual. The document then discusses the WHO analgesic ladder for treating mild, moderate, and severe pain with non-opioids, weak opioids like codeine, and strong opioids like morphine respectively. It also describes characterizing pain by duration, mechanism, origin, and situation.
Migraine is a severe headache accompanied by nausea, vomiting, light and sound sensitivity. It is caused by vasodilation of cranial blood vessels. Treatment includes acute medications like triptans and ergot alkaloids to constrict vessels and relieve symptoms. Prophylactic drugs like beta-blockers, antidepressants, and anticonvulsants are used to reduce migraine frequency. Triptans are the most effective acute treatment but can have cardiovascular side effects, while ergot alkaloids are less tolerated but more specific vasoconstrictors. Prophylaxis is recommended for those with frequent or severe migraines.
Migraine is a common neurological disorder characterized by severe headaches. Common triggers include diet, hormones, environment, and stress. Migraine attacks involve a headache phase with throbbing pain that worsens with activity along with symptoms like nausea and sensitivity to light/sound. Some people experience an aura phase before the headache with visual or sensory disturbances.
Treatment involves managing triggers, acute treatments like triptans to stop headaches, and preventive medications for those with frequent attacks. Preventive options include beta blockers, anti-seizure medications, and antidepressants, with the goal of reducing attack frequency and severity. Proper acute and preventive treatment along with lifestyle modifications can help manage migraine.
Migraine is a common type of headache characterized by severe throbbing pain, nausea, and sensitivity to light and sound. It is believed to be caused by swelling of blood vessels in the brain and is more common in women. Symptoms include headaches lasting 4-12 hours that may be preceded by visual disturbances. Treatment involves managing triggers to prevent headaches and using over-the-counter or prescription medications to stop headaches once they start or reduce their frequency. While migraines often continue for many years, symptoms typically lessen for most people after age 50-60.
Migraine and Tension Headache Diagnosis and Treatment Guideline, 1999–2013 Group Health Cooperative. , https://provider.ghc.org/all-sites/guidelines/headache.pdf
This document discusses different types of headaches and their treatment. It begins by defining primary and secondary headaches. Primary headaches include tension headaches, migraines, and cluster headaches. Migraines can be triggered by various factors and cause nausea. Secondary headaches have an underlying cause like head trauma. Treatment discussed includes acetaminophen, NSAIDs, and lifestyle changes. Medication overuse headaches are also addressed. The document provides guidance on treating specific headache types and exclusions for self-treatment.
Migraine and Tension Headache Diagnosis and Treatment GuidelineUtai Sukviwatsirikul
This document provides guidelines for diagnosing and treating migraines and tension headaches. It begins with criteria for differentiating migraine, tension, and cluster headaches based on location, intensity, duration, and associated symptoms. Potential alternative diagnoses are outlined if warning signs are present. Treatment guidelines recommend lifestyle modifications and avoiding medication overuse. Acute migraine treatment options include over-the-counter or prescription analgesics, triptans, dihydroergotamine, or ketorolac. Preventive medication options and follow-up monitoring are also discussed.
This document provides an overview of psychopharmacology and the use of psychotropic medications to treat mental health disorders. It discusses the roles of psychiatrists and psychopharmacologists in treatment and outlines major drug categories including antipsychotics, antidepressants, mood stabilizers, anxiolytics, and stimulants. Key concepts covered include mechanisms of action, side effects, drug interactions, principles of pharmacologic treatment, and the nurse's role in patient education.
Pharmacological and non pharmacological treatment of primary headacheswael ezzat
This document discusses various treatment strategies and medications for acute and preventive migraine treatment. It describes three approaches to treating acute migraines - step care across attacks, step care within attacks, and stratified care. For preventive treatment, it outlines common medication classes used, including beta-blockers, antidepressants, anticonvulsants, calcium channel blockers, and botulinum toxin. It stresses the importance of lifestyle changes, behavioral therapy, and addressing comorbidities for chronic migraine treatment.
Migraines are severe headaches often preceded by sensory warning signs like flashes of light and nausea. They have been documented for over 7,000 years and theories about their cause have evolved from humors rising in the body to increased blood flow in the brain. Migraines involve four phases - prodrome, aura, headache, and postdrome. Current theories suggest they are caused by cortical spreading depression leading to neurogenic inflammation and vascular changes in the brain. Treatment involves avoiding triggers, medications like triptans to abort attacks, and preventative medications like beta blockers, antidepressants, or anti-seizure drugs to reduce frequency.
Pharmacology topic, Unit four of the drugs known as analgesic_ANALGESICS_BM.pptxloreensinkende
This document discusses the classification of analgesics. It describes three main groups:
1. Opioid (narcotic) analgesics such as codeine, morphine and pethidine which act centrally to relieve moderate to severe pain and cause side effects like addiction, sedation and respiratory depression.
2. Non-opioid (non-narcotic) analgesics like paracetamol, aspirin and ibuprofen which act peripherally to relieve mild to moderate pain and have anti-inflammatory properties but no addiction potential. They can cause gastric irritation.
3. Antimigraine drugs like ergotamine which is used when headaches are unresponsive to other analgesics and may cause side effects
This document provides information on migraine including classification, pathophysiology, treatment of acute attacks, and preventive therapy. It notes that migraine is a recurrent headache disorder characterized by attacks lasting 4-72 hours with symptoms like throbbing pain and sensitivity to light/sound. Treatment involves analgesics, triptans, or ergot derivatives for acute attacks and medications like propranolol, amitriptyline or topiramate for prevention. The pathophysiology involves dilatation and constriction of cranial blood vessels triggered by the trigeminal nerve.
Pain management strategies & effects on wellbeingmiranda olding
Overview of pain, common pain management strategies and their effects on wellbeing. Side effects, effects on wellbeing, Covers Pain cycle, Persistent or chronic pain, pain gate theory, pharmaceutical and non-pharmaceutical or pain treatments, including complementary therapies, electrotherapies, psychological therapies for pain.
Written for student OT conference 'Perspectives on Wellbeing' Feb 2016
Unit II D Anti-migraine Drugs and its side affectwajidullah9551
This document discusses drugs used to treat migraine headaches and trigeminal neuralgia. It covers the classification, pathophysiology, diagnostic criteria, types and stages of migraine. Common antimigraine drugs discussed include triptans, ergot alkaloids, NSAIDs, and drugs used for migraine prophylaxis. Trigeminal neuralgia is described as a sudden, stabbing pain limited to areas supplied by the trigeminal nerve. Carbamazepine is the drug of choice for trigeminal neuralgia, while other anti-convulsants and non-pharmacological measures are also outlined. The nursing role in assessing contraindications to prevent complications is mentioned.
This document discusses pain and its classification into nociceptive and neuropathic pain. It also discusses acute and chronic pain and different types of pain such as cancer and non-cancer pain. Pain is assessed using a pain scale and choice of drug depends on patient's self-reported pain severity. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for mild pain and can be combined with opioids. Acetaminophen is also discussed along with its dosing, mechanisms of action, and toxicity. Side effects and risks of various NSAIDs like ibuprofen, indomethacin, and naproxen are summarized.
This document provides an outline on depression, antidepressant drugs, and related nursing care. It discusses types of depression like major depressive disorder and dysthymic disorder. It then covers the four main classes of antidepressant drugs - SSRIs, TCAs, atypical antidepressants, and MAOIs. For each drug class, it discusses mechanisms of action, indications, dosages, drug interactions, side effects, and relevant nursing considerations. The document aims to inform nurses on properly assessing, treating and caring for patients taking antidepressants.
Chili's is launching a new kids menu called Chili's Clip for Kids Kick-off. The new kids menu will feature kid-friendly meals and snacks at an affordable price point. Chili's hopes the new kids menu will attract families with children and increase sales during family-friendly hours on weekday evenings and weekend lunches.
Patients at Norton Children’s Hospital were feeling the love this past Valentine’s Day. Local radio station 102.3 The Max gathered valentines from the community as part of the Cupid’s Kids program.
Dieting is not easy no matter how simple the diet gurus make it sound. But do certain foods help you lose weight faster? Recent studies have identified a handful of foods that seem to work.
This document summarizes the toxicity of several common Christmas plants. Christmas cactus, Christmas trees, and poinsettias are considered nontoxic, though eating large amounts may cause minor issues like rashes or upset stomachs. Holly berries, Jerusalem cherry, and mistletoe berries are poisonous if consumed, and can cause effects ranging from nausea to death depending on the amount ingested.
Today is National Women’s Health & Fitness Day. To celebrate, Norton Women’s Sports Health asked local women why fitness is an important part of their lives. We got some great answers!
Being average doesn’t seem like much to strive for, yet it can mean everything for children who yearn to do things that other kids do. Camp Brave Hearts gives these children that chance during a week at the Center for Courageous Kids in Scottsville, Kentucky. Children ages 6 to 16 who have congenital heart disease, require medical treatment for heart disease or have undergone heart surgery get to experience summer camp as it was meant to be — the adventure of a lifetime!
The document provides tips for choosing clothing for a Splash 'n' Dash 5k run/walk event where participants will get wet. It recommends choosing lightweight, breathable fabrics and styles that allow freedom of movement when wet. Accessories like sunglasses, wide-brim hats, and water bottles are also suggested to help participants stay comfortable and hydrated during the event, which benefits Kosair Children's Hospital.
The document provides tips for choosing clothing for a Splash 'n' Dash 5k run/walk event where participants will get wet. It recommends choosing lightweight, breathable fabrics and styles that allow freedom of movement and won't cause chafing when wet. Sunglasses and hats are also suggested to protect from the sun during the outdoor water-themed event. Proceeds will benefit Kosair Children's Hospital.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
The document discusses the benefits of meditation for reducing stress and anxiety. Regular meditation practice can help calm the mind and body by lowering heart rate and blood pressure. Making meditation a part of a daily routine, even if just 10-15 minutes per day, can offer improvements to mood, focus, and overall feelings of well-being over time.
April is Child Abuse Prevention Month. All of us play a role in stopping this preventable tragedy that kills and injures thousands of our children every year. Join our caregivers to #StopChildAbuse. Learn more at DontHurtChildren.com.
Pictured are Kosair Children's Hospital employees and residents.
This document provides a sample menu for a holistic approach to eating. The breakfast includes salmon sausage or egg whites, mixed berries, grapefruit, nuts, whole grain toast with avocado, oatmeal prepared with soy milk and water and topped with berries and nuts. Lunch includes a mixed green salad, tuna or salmon in a tortilla wrap with hummus and vegetables, and a quinoa salad. Dinner options consist of wild salmon, grilled chicken, brown rice, sautéed vegetables, baked sweet potato, steamed kale and a mixed green salad. Snacks between meals include an apple with nut butter, hummus and vegetables, trail mix, and Greek yogurt with nuts and berries.
Topic 3 holistic approach to eating presentation handoutNorton Healthcare
This document discusses the importance of nutrition and a holistic approach to eating. It makes the following key points:
1. Nutrition plays a role in 8 of the top 10 causes of death in the US, yet receives little attention in health sciences education. There is a disconnect between what we eat and our health.
2. Major industries like healthcare, food, and agriculture contribute to poor health outcomes. Healthcare lacks focus on prevention and nutrition education. The food industry promotes processed foods over whole foods.
3. Adopting a whole foods, plant-based diet can help address obesity, chronic disease, and overall sickness in the US population. Eating slowly and mindfully also supports digestion and health.
This document provides an exchange list for healthy food choices organized into categories of carbohydrates from grains/starches, vegetables, fruit, proteins from plants, proteins from eggs/fish/poultry/dairy, and fats. It lists various foods and their serving sizes that are equivalent in carbohydrates, proteins, fats, and other nutrients. The exchange lists are intended to help people make balanced food selections as part of a healthy diet.
APOE Gene Diet is a registered trademark that provides information on different APOE gene variants and their associated risks for cardiovascular disease. It recommends gene-specific diets and lifestyles to support a healthy Gene Supportive Environment for each variant. The document outlines the different variants, their prevalence in the population, toxic clearance levels, and optimal diets, exercise, supplements and alcohol consumption based on the scientific literature to maintain cardiovascular health for each gene type. It cautions that statistics may not apply to individuals, who should work with their practitioner to determine their unique needs.
This document summarizes evidence from research on various complementary and integrative therapies including massage, aromatherapy, touch therapies like Reiki, and music therapy. It discusses challenges in researching individualized and natural treatments, and presents results from studies showing benefits like reduced pain, anxiety and nausea from therapies like massage, aromatherapy, and music. It also outlines programs that have successfully implemented complementary approaches in hospital settings, improving patient outcomes and reducing costs.
This document provides an overview of herbs and supplements presented by Dr. Rachel Busse. It discusses the high rate of patient supplement use, potential risks including interactions and lack of regulation. Specific supplements are reviewed for their uses, dosages, and precautions when treating conditions like mood disorders, sleep, menopause, liver health, inflammation, arthritis, and more. Herbal teas and "kitchen medicines" made from common herbs are also outlined. Sources for additional information on supplements are recommended.
This document contains slides from a presentation on stress reduction. It discusses how stress affects healthcare professionals and patients. It defines stress and identifies its causes such as overwork, role ambiguity, and understaffing. Long-term stress can increase risks of health issues like heart disease, diabetes and mental health problems. The presentation recommends organizational changes, stress management training, and coping strategies like mindfulness, social support and seeking help to reduce workplace stress.
This presentation discusses and compares Reiki and Healing Touch, which are energy-based therapies that promote self-healing. Both therapies help restore harmony and balance in the body's energy system. While they are similar, Healing Touch provides standardized training and certification. The presentation explores the history and meanings of Reiki and Healing Touch, demonstrates techniques for self-care, and reviews limited research that has shown benefits such as reduced anxiety and pain.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
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2. Disclaimer
This talk is not inclusive of all medications
used to treat migraine; this is a simplified
discussion of the common medications used
in treating migraine. There is likely going to
be a medication you are on or have been
treated with not discussed in this lecture,
that does not mean it is not effective or not
used in the treatment of migraine.
3. Treating migraine
• One of the biggest factors that we stress in the treatment of
migraine is thorough evaluation of triggers and lifestyle
modifications
– Diet
– Sleep
– Exercise
– Hydration
– Stress management
• These are all topics that at various times are discussed in
other headache school sessions
• This is a talk about medications, assuming that we are already
looking into and discussing other lifestyle modifications
4. Strategies for treating migraine
• Treating the headache attacks
– Rescue medications / abortive therapy
• Preventing headache
– Prophylactic / preventative therapy
– Goal of preventative therapy is reducing the frequency,
severity, and duration of attacks
– Success is defined as a 50% reduction
– Important to remember that it is management, not a “cure”
5. Rationale for treating migraine
• When to choose a preventative therapy?
– There is no set in stone guideline
– Individualized
• Is the patient willing to take a daily medication knowing
that there is a potential for side effects?
• Is the patient failing rescue medications?
• Is the patient experiencing disability (missed work,
school, or family functions)?
6. Rescue Medications
• Primary goal is to achieve relief of pain,
associated symptoms, and disability within 2
hours of use
• Goal is to use rescue medications 2 or fewer
times per week to prevent developing
medication overuse headache
7. Rescue Medications
• It is important to treat the headache as soon as
possible, as time goes on the medications become
less effective
• Allodynia is defined as pain resulting from
stimulation that would not normally be perceived as
noxious (ie. light touch of the skin)
– To the patient this is perceived as scalp tingling or pain
when lightly touched during a migraine
– To physicians this means that the deep parts of the brain
have been stimulated by the migraine attack and it is often
times more difficult to treat
8. Allodynia
• Once the deeper parts of the brain are activated the
migraine attack becomes much more difficult to treat
– A study using injectable sumatriptan (to be discussed later)
found that in patients without allodynia 93% were free of
pain at 2 hours, but only 15% of patients with allodynia
were pain-free at 2 hours
• The take home message is to treat aggressively and
treat early to improve chances of becoming pain-free
with minimal medication use
10. Rescue Medications
• In treating migraine unlike treating other conditions
(ie. high blood pressure) we often times suggest
using higher dose medications initially and backing
down the dose if side effects are experiences, rather
than over time escalating doses
– So it is important to understand what potential side effects
can occur with medications and understand that the goal is
being pain-free with TOLERABLE side effects rather than
being with pain and no side effects
11. Rescue Medications
• Need to use caution to avoid medication
overuse headache by using rescue
medications frequently
12. Medication Overuse Headache
• Headache present on ≥15 days/month
• Regular overuse for ≥3 months of one or
more drugs that can be taken for acute
and/or symptomatic treatment of headache
• Headache has developed or markedly
worsened during medication overuse
• Headache resolves or reverts to its previous
pattern within 2 months after discontinuation
of overused medication
13. Medication Overuse Headache
The Cleveland Clinic Manual of Headache Therapy p. 156
Bigal ME, et al. Headache. 2008;48:1157-1168.
Bigal ME, et al. Pain. 2009;142:179-182.
14. Nonspecific Migraine Medications
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
• Over 20 forms of NSAIDs available in the US, many
available over-the-counter
• Have anti-inflammatory effects as well as analgesic
(pain relief) effects
• Not processed through the liver
• Kidney metabolism
– Very important for patients with kidney disease, on other
medications that have effects on the kidneys, and in
patients with extreme vomiting (dehydration can lead to
kidney problems)
• Can lead to stomach bleeding with frequent use
15. NSAIDs
• Can be used alone or in combination with
other medications (ie. triptans)
• Are non-sedating
• Have been shown to be effective in treatment
of patients with allodynia
• Because of the availability there is significant
problems with overuse, particularly leading to
medication overuse headache
16. NSAIDs
• Ibuprofen (Advil, Motrin) 400-800mg
• Naproxen (Aleve) 500-550mg
– Available combined with sumatriptan (Treximet)
• Diclofenac (Cambia, Cataflam, Voltaren) 50mg
– Orally disintegrated packets (Cambia) have very rapid
onset of action
• Ketorolac (Toradol)
– Oral form not frequently used
– IV or IM form can be used for prolonged migraine
17. Acetaminophen
• Acetaminophen (Tylenol)
• Most people do not find useful for severe
migraine
• Can be used for mild headache
• Typical dose is 1000mg at onset of headache
• Often times used in combination products (ie.
Fioricet, Midrin, etc)
• Can lead to medication overuse headache
• With heavy usage can lead to liver toxicity,
otherwise no significant side effects
18. Isometheptene
• Midrin
– Contains isometheptene, acetaminophen, and
dichloralphenzone
– Two capsules at onset, followed by one capsule
every hour until relief is achieved (max of 5 per 12
hours)
– Side effects similar to components, dizziness is
common
– Modest effects
– Sparsely available
19. Butalbital
• Combination product
• Butalbital / acetaminophen / caffeine
– Esgic, Fioricet
• Butalbital / aspirin / caffeine
– Fiorinal
• Side effects include incoordination, disinhibition, memory
problems, drowsiness
• If used for extended periods of time and then discontinued
can cause withdrawal seizures
• Significant risk of medication overuse headache
– Studies show when used as few as 5 times per month can lead to MOH
20. Excedrin
• Combination of aspirin, acetaminophen, and
caffeine
• Can be used for mild to moderate migraine
• Due to the multiple products combined there is
significant risk of medication overuse headache
• Available OTC (unregulated by treating physicians
patients can take unlimited amounts)
• In specialty headache clinics this is probably the
most frequently overused medication and causes
more frequent headache
21. Anti-nausea medications
• Can often times alone or in combination be effective
in treating migraine
– Metoclopramide (Reglan)
– Prochlorperazine (Compazine)
– Promethazine (Phenergan) to a lesser extent
• Most common side effects are drowsiness and
dizziness
• More significant side effects include dystonia
(sustained muscle contraction) and akathisia (sense
of restlessness) which can be treated with Benadryl
22. Opiates
• Worth mentioning, but in the hands of
headache specialists are not frequently used
• In migraine, opiates are not well absorbed,
they are associated with increased nausea,
and sedation
• Very quickly can lead to physical dependence
and are quite notorious for causing
medication overuse headache
25. Triptans
• Introduced in the 1990s
• Often times considered the drug of choice in
treating migraine
• Selective agonists (activators) of serotonin
blocking the release of other inflammatory
chemicals during a migraine attack
26. Triptans
• Available in many different brand names with
varying time of onset and duration of action
• Available in a variety of delivery methods
– Oral tablet
– Oral disintegrating
– Nasal
– Injection
– Patch (in development)
27. Triptans
• Side effects
– Narrow coronary blood vessels by 10-20% (avoid use in
individuals with a history of coronary or cerebro-vascular
disease or uncontrolled risk factors)
– Tighten of the throat, chest, jaw, neck, and limbs
– Numbness of the limbs and around the mouth
– Hot and cold sensations
• Through to be due to esophageal (not heart) related spasm and
muscle contractions
• If warned in advance, most patients can tolerate side effects with
the benefit that they give
28. Triptans
• “Patients vary more than triptans”
• Meaning, just because one did not help or caused
side effects does not mean that another will do the
same
– I give the example of Coke and Pepsi – it’s basically the
same stuff but some people like one and some people like
another, and you won’t know until you’ve tried them
• Or that different routes of administration won’t have
a different effect
30. Sumatriptan
• Imitrex, Statdose, Sumavel, Alsuma
• First triptan brought to market (1991)
• Available oral, nasal, and subcutaneous injection
• Available as a generic
• Oral dose is 25, 50, 100mg – maximum per 24 hours is 200mg
– Available in combination with naproxen as Treximet
• Subcutaneous (SC) forms (Statdose, Sumavel, Alsuma) are
6mg (max 12mg / 24 hours)
– Have much quicker onset of action (10 minutes) and are great for
patients with significant nausea and vomiting
– Statdose and Alsuma use a needle, Sumavel is needle-less
• Nasal spray is not used all that frequently
31. Quick acting triptans
• Almotriptan (Axert)
– 6.25mg / 12.5mg; max per day is 25mg
• Rizatriptan (Maxalt)
– 5mg / 10mg / 10mg MLT (dissolvable tablet); max per day
is 30mg
• If using propranolol need to use 5mg dose
• Eletriptan (Relpax)
– 20mg / 40mg; max is 80mg per day
• Zolmitriptan (Zomig)
– 2.5 / 5mg; available as nasal spray (5mg); max is 10mg per
day
32. Slow acting triptans
• Naratriptan (Amerge)
– 1, 2.5mg; max is 5mg per day
– Available as generic
• Frovatriptan (Frova)
– 2.5mg; max is 7.5mg per day
• These are useful for menstrual migraine (as a week-
long preventative)
• Also used in combination with another drug (ie.
naproxen or Cambia)
33. Ergots
• Ergotamine tartrate available since 1925
• Dihydroergotamine (DHE) more refined
version available since 1945
– These were the only available migraine specific
medications until triptans introduced in 1990s
• Effect many chemicals in the nervous system
which explains why they are so effective, but
also explains the side effects
34. Ergots / DHE
• Nausea is the major side effect
– May actually increase nausea of migraine rather than improve it
• Again contraindicated in patients with vascular disease,
coronary artery disease, etc.
• Available IV (hospital use)
• Intramuscular – can be administer at home
• Intranasal (Migranal) – very easy to use at home
– Inhaled in each nostril and then repeated in 15 minutes
– Much less effective than IV / IM
• Orally inhaled DHE (Levadex) coming to market soon
– Inhaled orally at home with blood levels as high as IV, but with less
nausea
• Should be a great drug when commercially available (maybe later this
year)
36. Preventative Medications
• There are no “migraine specific” medications
used in the prevention of migraine
• Use medications from other classes
– Blood pressure medications
– Antiseizure medications
– Antidepressants
– Serotonin antagonists
– Vitamin supplements
– Botox
37. Preventative Medications
• Important to identify patients that are using
frequent rescue medications and may be on
the way to developing medication overuse
headache
• Patients who have disabling headache that is
not easily treated with rescue medications
• Ideally treat multiple conditions with a single
medicatio
– ie. high blood pressure and migraine
38. Antidepressants
• Tricyclic antidepressants
– Amitriptyline (Elavil)
– Nortriptyline (Pamelor)
– Protriptyline (Vivactil)
• Side effects
– Elavil and Pamelor are sedating and taken at night (useful
for patients with sleep trouble)
– Vivactil is stimulating, but needs to be taken 3x per day
– Cause dry mouth, constipation, weight gain
– At high doses can cause heart related issues that may
require an EKG to be checked
39. SSRI / SNRI
• SSRI
– Fluoxetine (Prozac)
– Paroxetine (Paxil)
– Fluvoxamine (Luvox)
• SNRI
– Venlafaxine (Effexor)
– Duloxetine (Cymbalta)
– Desvenlafaxine (Pristiq)
• SNRIs tend to be more effective for migraine than
SSRIs
– Venlafaxine (Effexor) has the best evidence for use in
prevention of migraine
40. SSRI / SNRI
• Side effects
– Weight gain
– Sexual dysfunction
– Sedation
– Nervousness
41. Antiseizure Medications
• Recently have become most frequently used
medications for prevention of migraine
– Topiramate (Topamax)
– Valproate (Depakote)
– Gabapentin (Neurontin)
– Zonisamide (Zonegran)
42. Topiramate (Topamax)
• One of the most frequently used medications in the
prevention of migraine
• Has several advantages, but also does have some
side effects to be aware of
• Effective in nearly 50% of patients that use it
• Rather than weight gain, often times causes weight
loss
• Optimal dose is 50mg twice per day
– If side effects occur, sometimes may use nighttime only
dosing
43. Topiramate (Topamax)
• Side effects
– Up to 13% of patients experience cognitive dysfunction of trouble with
processing information and trouble finding words
– Numbness / tingling of fingers, toes, face
• Actually a predictor of which patients will benefit from topiramate use
• Potassium supplementation can help
– Risk of kidney stones
– Glaucoma
– Reduced sweating (important in athletes / overheating)
• Recently identified birth defects
– Oral cleft (palate, lip) 11 times higher than general population
– Rated as Category D for pregnancy
• Reduced oral contraceptive effectiveness
– At doses greater than 200mg / day
44. Valproate (Depakote)
• Quite effective, but less commonly used due to side
effect potential
• Optimal dose is 500 – 1,500mg per day
• Side effects
– Weight gain
– Hair loss
– Pancreatitis
– Liver problems
• Significant effects with women of child-bearing
potential
– Neural tube defects (ie. spina bifida)
45. Gabapentin (Neurontin)
• Less commonly used
• Optimal dosing is 900 – 2,400mg
– Needs to be dosed 3x per day
• Side effects
– Drowsiness
– Dizziness
• No drug interactions, no effect on kidneys or
liver
• Sometimes used as a rescue medication
46. Zonisamide (Zonegran)
• Similar to topiramate
• Sometimes effective in patients that respond
to topiramate but experience side effects
• Side effect profile similar
• Optimal dosing not exactly known, but most
suggest around 200mg at night
47. Blood Pressure Medications
• Beta blockers
• Calcium channel blockers
• Other blood pressure medications
– Not frequently used
• Useful in patients with co-existent high blood
pressure
48. Beta Blockers
• Propranolol
• Timolol
• Atenolol
• Metoprolol
• Nadolol
– Lower blood pressure and heart rate
• Can lead to light-headedness
– Can reduce aerobic capacity
– Worsen asthma
– Avoid in diabetics
– Can worsen depression
49. Calcium Channel Blockers
• Verapamil
• Diltiazem
– Generally well tolerated
– Often times more useful in patients with migraine
with aura
– Side effects include light-headedness,
constipation, and swelling of legs
50. Serotonin antagonists
• Rarely used outside of headache specialty
clinics
• Methylergonovine (Methergine)
– Similar to methysergide (Sansert) which is no
longer readily available
– Usually used 3-4x per day
– Triptans should not be given concominantly
51. Vitamin Supplements
• Not as well studied as prescription medications (product of
financing of studies)
• Magnesium
– 400+mg / day
– Diarrhea can occur
• Riboflavin (B2)
– 25 – 400mg / day
– Will discolor urine
• Coenzyme Q10
– 100mg 3x / day
– Costly (sometimes)
• Butterbur and Feverfew also felt to be effective
52. Botox
• OnabotulinumtoxinA
• Famous for being used for “wrinkles”
• Found to be effective in patients with chronic
migraine
– Greater than 15 days of headache per month for
greater than 3 months
• In clinical trials patients using opiates and
butalbital were excluded as they tend to do
worse
53. Botox
• 155 units injected into 31 sites given every 3
months
• Minimal side effects
– Injection site pain is largest
• Up to 9 days less per month of headache
• FDA approved
54. PREEMPT Protocol Fixed-dose, Fixed Injection Sites; one size fits all
• In the US, Botox is available in 2 vial • This comes out to 4 (1 ml) syringes,
strengths with 100 or 200 Units all 30 gauge ½ inch needles
•Normal Saline is the diluent • Each injection is 0.1 cc
• For the 100 unit vial, 2 cc Normal •There are 5 units onabot/0.1 ml
Saline; For the 200 unit vial, 4 cc NS
Blumenfeld A et al. Headache 2010;50:1406-1418 .
55. PREEMPT pooled analysis: mean change from baseline
in frequency of headache days (primary)
Double-blind
phase: patients on
Open-label phase: all • Patients treated with
patients on onabot
onabot or pbo onabot averaged of 8.2
fewer HA days/month
at Wk 24 vs placebo,
6.2 HA d/mo; p<0.001)
days from baseline (days/28-day period)
••Onabot (n=688)
Mean change in frequency of headache
Onabot (n=688)
••Pbo (n=696)
Pbo (n=696) • Patients receiving
placebo first, that is 3
cycles, never catch up
to those who received
5 cycles, suggesting
cumulative benefit
Headache days at baseline: 19.9 onabot vs 19.8 placebo, p=0.498.
Dodick DW et al. Headache 2010;50:921–936.
56. Conclusions
• Rescue medications
– Use migraine specific medications as much as
possible
– Treat as early as possible in the attack
– Add NSAIDs to triptans if necessary
– Avoid opiates and butalbital as much as possible
– Limit rescue medications to 10x per month if
possible
57. Conclusions
• Preventative treatment
– When migraine is frequent or disabling
pharmacologic prevention should be used to avoid
medication overuse
– Individualize treatment with other medical
conditions
– Give medications 2-3 months to see if they are
effective
– Set realistic expectations (not a cure)
58. Questions?
Discussion
Join us for our future classes
For more information visit
NortonHealthcare.com/headacheandconcussion
59. Norton Headache and Concussion Center
Headache School
• How Diet Affects • Headache related to injury
Headaches August 8 • 6 to 7:30 p.m.
May 16 • 6 to 7:30 p.m.
• What is a migraine aura?
• Women and Headaches September 12 • 6 to 7:30 p.m.
June 13 • 6 to 7:30 p.m.
• Alternative headache
• Biofeedback and stress treatments
management October 17 • 6 to 7:30 p.m.
July 11 • 6 to 7:30 p.m.