ANALGESICS: HEADACHE, PAIN, & FEVER Self- Care and Over- The- Counter Options

Transcription

1 ANALGESICS: HEADACHE, PAIN, & FEVER Self- Care and Over- The- Cunter Optins Learning Objectives Cmpare and cntrast the different OTC drug therapies utilized fr pain management Describe the different types f headache List lifestyle mdificatins that can be utilized t reduce headache frequency and pain Understand the d s and d nt s f fever management DRUG CLASS DRUG NAMES INDICATIONS OTC DOSE ACETYLATED SALICYLATES Aspirin Pain, fever, anti- inflammatry Apirin 650 mg every 4 hurs as needed (MAX 4 g per day) NON- ACETYLATED SALICYLATES ACETAMNOPHEN NSAIDs Magnesium Acetaminphen Ibuprfen Salicylate Naprxen Pain, fever, anti- inflammatry Magnesium Salicylate 650 mg every 4 hurs (MAX 4 g per day) Pain and fever NO anti- inflammatry ACETAMINOPHEN 325 mg every 4 hurs as needed (MAX 4 g per day) Pain, fever, and anti- inflammatry IBUPROFEN 200 mg every 4 hurs (MAX 1200 mg per day) NAPROXEN 220mg every 12 hurs (MAX 660 mg per day) SIDE EFFECTS CAUTION! (cnsult pharmacist r MD befre taking) OTHER INFO GI irritatin/ bleeding, anemia, tinnitus, nausea Uticartia- angiedema Kidney prblems Cltting disrders Vitamin K deficiency Onset f effect is same regardless f frmulatin DO NOT GIVE TO CHILDREN! Similar t aspirin Similar t aspirin DO NOT GIVE TO CHILDREN Okay t use if patient has aspirin allergy Side effects are RARE, but can include nausea Liver prblems Dehydratin Malnutritin Kidney prblems Okay t use if patient has aspirin allergy DO NOT DRINK ALCOHOL ON THIS DRUG Nausea, heartburn, sun- sensitivity, dizziness/ fatigue Heart failure Kidney prblems Asthma GI prblems Take with a meal r with a glass f milk t cut dwn n side effects

2 HEADACHE SELF- CARE APPROPRIATE HEADAHE CARE Tensin Headache Migraine Headache Sinus Headache Lcatin Bilateral Usually unilateral Face, frehead, perirbital area Nature Diffuse aching, tight, pressing, cnstricting pain. Feels like a vice squeezing the head. Caused by tight muscles in the neck and upper back. Triggered by stress, anxiety, r fatigue. Thrbbing may be preceded by an aura (visual disturbances), nausea, intlerance t light and sund, vertig, ringing in the ears, and irritability Pressure behind the eyes r the face especially upn bending ver Onset Simultaneus with sinus Mre gradual Sudden prblems, including purulent discharge Duratin Minutes t days Hurs t 2 days Reslves with sinus symptms What OTC med? (take as sn as yu ntice the headache is beginning fr best results) Analgesics (acetaminphen, ibuprfen, naprxen, aspirin) DIAGNOSIS MUST BE MADE BY MD Analgesics (acetaminphen, ibuprfen, naprxen, aspirin) Medicatins that MAY Trigger OTC Medicatins aspirin, aspirin, caffeine Prescriptin Medicatins triptans, pids, butalbital, ergtamine Using lnger than 3 mnths n a chrnic basis withdrawal headaches can ccur Decngestants (pseudephedrine, phenylepherine) & Analgesics (acetaminphen, ibuprfen, naprxen, aspirin) Nn- pharmaclgical Headache Treatments relaxatin exercises, stretching, and strengthening the affected muscles Maintain a regular schedule fr sleeping and eating Practicing methds t cpe with stress Use ice- packs and pressure applied t the frehead r temple (reduces pain assciated with acute migraine attack) Dietary Guidelines Avid fds that act as triggers Avid hunger and lw bld glucse (VERY IMPORTANT!!) Avid fd that are vasactive Red wine, aged cheese, artificial sweeteners, MSG, caffeine, chclate

3 Exclusins t Self- Care fr Headaches when t see the dctr Severe head pain (> 6 n a pain scale) Headache that persists ver 10 days with r withut treatment < 7 years ld High fever r ther signs n infectin Histry f liver disease r cnsumptin f > 3 alchlic drinks per day Headache related t a different disease (secndary headache) Symptms cnsistent with migraine, but n frmal diagnsis is made by a dctr CRITERION LOCATION SIGNS & SYMPTOMS PAIN HOW THINGS CAN GO WRONG TENDONITIS & OSTEOARTHRITIS BURSITIS Weight- bearing jints jints Dull jint pain and stiffness relieved by rest Warmth, redness, swelling, cepitus. Tendnitis pain lessens during exercise Bursitis pain is cnstant ONSET Years Excessive use GOOD FACTORS Therapeutic exercise Jint rest & immbilizatin SPRAIN & STRAIN Sprain: jint Strain: muscle Swelling, bruising, pain, and stiffening Hyperextensin (sprain ligament Strain tendn) RICE! REST ICE COMPRESSION ELEVATION CRAMP Muscles Pain lasting secnds t minutes sudden Prper hydratin Nt eating befre exercise RICE THERAPY HINTS & TIPS Apply ice in 10 minute intervals 3 t 4 times a day Apply cmpressin with an elasticized bandage Tightly wrap at the mst distal spt and decrease the tightness as yu cntinue t wrap. Cld, disclred, r swllen fingers/ tes indicate it s t tight! Elevate the injured area abve the level f the heart decreases swelling and relieves pain

4 PHARMACOLOGICAL PAIN THERAPIES Oral analgesics If swllen and painful then use an NSAID (ibuprfen, naprxen, etc) if pssible If n swelling take acetaminphen Tpical analgesics n systemic effect n pain depending n what yu take there is a different effect Cling effect camphr and menthl (aka Bengay, Icy- Ht) Paradxical pain capsaicin DO NOT USE ON AN OPEN WOUND!!!!! WHEN TO SEE THE DOCTOR Pain r injury is present after 10 days f treatment with OTC medicatin Pain is greater than 6 ut f 10, r severe immbilizatin Pain is chrnic (lasting lnger than 2 weeks withut therapy) FEVER WHAT? Bdy temperature higher than 98.6 F r 37 C Many causes HOW? The bdy makes PGE 2 in respnse t pyrgens. This substance elevates the thermregulatry set- pint in the hypthalamus. Bdy reacts with chills caused by peripheral vascnstrictin and muscle rigidity as the bdy attempts t stay in hmestasis. COMPLICATIONS OF FEVER Dehydratin Delirium/ cnfusin (seen with higher fever temperatures) Seizures Cma Irreversible nerve damage TREATMENT Pharmaclgical antipyretics will reduce the fever and alleviate discmfrt Inhibit PGE 2 synthesis by blcking prstaglandin synthesis TOP CHOICES: Ibuprfen regimen r Acetaminphen regimen Nn- pharmaclgical Drink PLENTY OF FLUIDS Wear light clthing and avid excess clthing d NOT bundle Cl (NOT COLD) envirnmental temperature Spnge bath in lukewarm water Evaluate temperature thrugh the curse f the day (abut an 2 hurs after each dse)

5 WHEN TO SEE THE DOCTOR Symptms f infectin (ear infectin, strep thrat, etc) anything that requires antibitics Patients with COPD, asthma, r heart failure Greater risk fr hypxia aka lw xygen levels Immunsuppressed Fever des nt reslve within 3 day f therapy with antipyretics Fever is ver 103 F r if there are signs f fever cmplicatins (delirium and dehydratin)