Treatments for Headache-free migraine
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Aura:
Treatment
(In a Page: Signs and Symptoms)
-
Migraine
–Avoid triggers (e.g., alcohol, stress, fatigue)
–NSAIDs and/or acetaminophen
–5-HT1 agonists (e.g., sumatriptan) are useful during the
headache phase and ergotamines (e.g., dihydroergotamine) are effective for status migraines; however, neither are effective to relieve aura
-
Epilepsy
–Status epilepticus: Stabilize patient and administer IV benzodiazepines and fosphenytoin
–Antiepileptics if risk for recurrent seizures: Phenytoin, carbamazepine, or valproate for generalized or partial seizures; ethosuximide or valproate for absence seizures; lamotrigine or valproate for mixed seizures
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Headache:
Treatment
(In a Page: Signs and Symptoms)
-
Tension-type headache: Regular exercise, stress management, tricyclic antidepressants, analgesics
-
Migraine headache: Avoid triggers; serotonin agonists (e.g., sumatriptan), NSAIDs, ergotomines
-
Temporal arteritis: High-dose corticosteroids
-
Meningitis: Search for and treat the primary source (e.g., pneumonia, sinusitis, neoplasm)
–Urgent antimicrobial administration for infections
–Treat inflammatory causes with steroids
-
Subarachnoid hemorrhage requires attention to airway, breathing, and circulation, and management of increased intracranial pressure (maintain normal blood pressure; hypertension may cause the aneurysm to rebleed, hypotension may cause cerebral ischemia); administer nimodipine to prevent cerebral vasospasm, seizure prophylaxis with IV phenytoin, surgery
-
Cluster headache: Oxygen inhalation for 5–10 minutes; serotonin agonists, ergotamines, and/or methysergide
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Abdominal Bruit:
Treatment
(In a Page: Signs and Symptoms)
-
Initial treatment is to stabilize and resuscitate the patient as needed
–Attention to airway, breathing, and circulation
–Immediate repair of ruptured abdominal aneurysm
Treat the underlying etiology
Vascular surgical consultation may be necessary for severely stenotic and/or symptomatic vessels
Nephrology consult may be needed for renal insufficiency or to help with appropriate medication choices
Treat hypertension if present
–Always avoid ACE inhibitors in patients with bilateral renal artery stenosis
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Abdominal Guarding:
Treatment
(In a Page: Signs and Symptoms)
-
Immediate attention to hemodynamic status and life-threatening disease
–Replace volume with normal saline and possibly a blood transfusion
–Evidence of hemorrhage (e.g., ruptured AAA, ruptured ectopic pregnancy) or early sepsis (e.g., perforated diverticulitis, perforated bowel) may be a life-threatening emergency that requires urgent surgical intervention
-
Place NG tube for obstruction or persistent vomiting
-
Administer broad-spectrum empiric antibiodics if a perforated viscus or intra-abdominal infection is suspected
-
Direct treatment toward the specific condition
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Headache:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Explanation and reassurance alone may provide relief
-
Avoid triggers
–Trauma, sunlight, insomnia, stress, diet, dehydration
-
Symptomatic treatment:
–Acetominophen, NSAIDs, Midrin, Fioricet, Fiorinal
–Selective serotonin-1 receptor agonists
–Dihydroergotamine (DHE); Migranal nasal spray
–Antiemetics
-
Prophylaxis
–NSAIDs, β-blockers, tricyclic antidepressants,
cyproheptadine, calcium channel blockers,
antiepileptic drugs, biofeedback
-
Cluster headaches
–Treated with inhalation of oxygen; sumatriptan
-
Pseudotumor
–Weight reduction, Diamox
–Optic nerve sheath decompression or shunting
>>
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Aura:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
When an aura rapidly progresses to the ictal phase of a seizure, quickly evaluate the seizure and be alert for life-threatening complications such as apnea. When an aura heralds a classic migraine, make the patient as comfortable as possible. Place him in a dark, quiet room and administer drugs to prevent the headache, if necessary.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Abdominal rigidity [Abdominal muscle spasm, involuntary guarding]:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
After palpating abdominal rigidity, quickly take the patient’s vital signs. Even though the patient may not appear gravely ill or have markedly abnormal vital signs, abdominal rigidity calls for emergency interventions.
Prepare to administer oxygen and to insert an I.V. line for fluid and blood replacement. The patient may require drugs to support blood pressure. Also prepare him for catheterization, and monitor intake and output.
A nasogastric tube may have to be inserted to relieve abdominal distention. Because emergency surgery may be necessary, the patient should be prepared for laboratory tests and X-rays.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Headache:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Depending on the type of headache, analgesics — ranging from aspirin to codeine or meperidine — may provide symptomatic relief. Other measures include identification and elimination of causative factors and, possibly, psychotherapy for headaches caused by emotional stress. Chronic tension headaches may also require muscle relaxants.
For migraine headaches, ergotamine alone or with caffeine may be an effective treatment. The Food and Drug Administration allows labeling of various analgesic preparations that include caffeine to state that they’re for the treatment of migraine headaches. Remember that these medications can’t be taken by pregnant women because they stimulate uterine contractions. These drugs and others, such as metoclopramide or naproxen, work best when taken early in the course of an attack. If nausea and vomiting make oral administration impossible, drugs may be given as rectal suppositories.
Drugs in the class of sumatriptan are considered by many clinicians to be the drug of choice for acute migraine attacks or cluster headaches. Drugs that can help prevent migraine headaches include antidepressants (such as nortriptyline or fluoxetine), beta blockers (propranolol), and calcium-channel blockers (verapamil). Corticosteroids provide short-term relief for some patients with cluster headaches.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
West Nile encephalitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
There is no specific therapy utilized to treat West Nile encephalitis and no known cure. Treatment is generally aimed at controlling the specific symptoms. Supportive care, such as I.V. fluids, fever control, and respiratory support, is rendered when necessary.
There is no vaccine present to prevent the transmission of West Nile encephalitis. Research trials are underway to determine if ribavirin, an antiviral drug, may be helpful.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Abdominal trauma:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
I.V. fluid replacement, surgical repair, analgesics, antibiotics
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Aura:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
When an aura rapidly progresses to the ictal phase of a seizure, quickly evaluate the seizure and be alert for life-threatening complications such as apnea. When an aura heralds a classic migraine, make the patient as comfortable as possible. Place him in a dark, quiet room and administer drugs to prevent the headache, if necessary.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Abdominal rigidity [Abdominal muscle spasm, involuntary guarding]:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
After palpating abdominal rigidity, quickly take the patient’s vital signs. Even though the patient may not appear gravely ill or have markedly abnormal vital signs, abdominal rigidity calls for emergency interventions.
Prepare to administer oxygen and to insert an I.V. line for fluid and blood replacement. The patient may require drugs to support blood pressure. Also prepare him for catheterization, and monitor intake and output.
A nasogastric tube may have to be inserted to relieve abdominal distention. Because emergency surgery may be necessary, prepare the patient for laboratory tests and X-rays.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Headache:
Treatment
(Handbook of Diseases)
Depending on the type of headache, treatment interventions range from relaxation techniques, massage, and biofeedback to pharmacologic agents. Tricyclic antidepressants, beta-adrenergic blockers, and anticonvulsants may be prescribed for headache prevention; nonsteroidal anti-inflammatory drugs (NSAIDs), combination NSAIDs with caffeine, ergotamines, and dopamine antagonists may be used for abortive measures. Narcotic agents are generally avoided or may be limited to twice weekly.
Abortive therapy using the synthetic form of serotonin (sumatriptan) is available in an oral form and as a nasal spray and can easily be carried for immediate use.
Other measures include identification and elimination of causative factors, stressors, or stimuli that might trigger an attack such as in the migraine-type headache. Diet history and examination of lifestyle patterns may help identify causative agents.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
West Nile encephalitis:
Treatment
(Handbook of Diseases)
No specific therapy is used to treat West Nile encephalitis, and no known cure exists. Treatment is generally aimed at controlling the specific symptoms. Supportive care, such as intravenous fluids, fever control, and respiratory support, is rendered when necessary.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Aura:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
When an aura rapidly progresses to the ictal phase of a seizure, quickly evaluate the seizure and be alert for life-threatening complications such as apnea. When an aura heralds a classic migraine, make the patient as comfortable as possible. Place him in a dark, quiet room and administer drugs to prevent the headache, if necessary.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Headache:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient and his family or caregiver how to recognize signs of reduced LOC and seizures. Discuss ways to maintain a safe, quiet environment and reduce environmental stress, if indicated. Discuss the use of analgesics to ease the headache.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Aura:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Advise the patient to keep a diary of factors that precipitate each headache or seizure as well as associated symptoms to help you evaluate the effectiveness of drug therapy and recommend lifestyle changes.
Patient teaching
▪ Teach the patient stress-reduction measures.
▪ If the patient recognizes the aura as a warning sign, tell him to prevent the headache by taking appropriate medications.
▪ Explain diagnostic tests or procedures.
▪ Explain the underlying disorder and treatment plan.
▪ If the patient has a seizure disorder, emphasize the importance of taking anticonvulsants as directed.
▪ Stress the importance of regular follow-up appointments for blood studies.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Headache:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the patient's vital signs and LOC.
▪ Watch for a change in the headache's severity or location.
▪ To help ease the headache, administer an analgesic, darken the patient's room, and minimize other stimuli.
▪ Prepare the patient for diagnostic tests, such as skull X-rays, a computed to-mography scan, lumbar puncture, or cerebral arteriography.
Patient teaching
▪ Explain all procedures and treatments to the patient.
▪ Discuss the signs of reduced LOC and seizures that the patient or his caregivers should report.
▪ Explain ways to maintain a safe, quiet environment and reduce environmental stress.
▪ Discuss the proper use of analgesics.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Abdominal rigidity [Abdominal muscle spasm, involuntary guarding]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the patient closely for signs of shock.
▪ Place the patient in a position of comfort.
▪ Administer analgesics, as ordered, and evaluate their effect.
▪ Withhold food and fluids.
▪ Administer an I.V. antibiotic as ordered if emergency surgery is required.
▪ Prepare the patient for diagnostic tests which may include blood, urine, and stool studies; chest and abdominal X-rays, computed tomography, magnetic resonance imaging, gastroscopy, and colonoscopy.
Patient teaching
▪ Explain diagnostic tests or surgery the patient will need.
▪ Tell the patient about any food or fluid restrictions.
▪ Show him how to position himself for comfort.
▪ Explain the underlying disorder and treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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