By Lawrence Robbins
This state of the art ebook will conceal a number of points of headache administration, with a spotlight on tricky sufferers. sensible, step by step recommendation for treating tough complications, together with migraine, refractory and cluster complications, could be supplied intimately in addition to the best way to method sufferers of alternative a while and people with mental problems. targeted and complicated case experiences and whole motives to the immense array of medicines may also be featured. Authored by way of one of many best specialists on refractory complications, complicated Headache administration should be a useful advisor for the resident or clinician and an easy-to-read source for plenty of patients.
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Additional info for Advanced Headache Therapy: Outpatient Strategies
Antiemetics are important adjuncts for those with nausea. Ondansetron lets people get on with their day without sedation. We also use the other antiemetics, such as metoclopramide or prochlorperazine, which are somewhat sedating. The goal is to keep people out of the emergency room (ER), and the antiemetics help in this regard. I do use opioids and butalbital in selected patients. We limit their use, but nine out of ten patients do not overuse them. It is the 10 % who create problems. Butalbital compounds are controversial, and are not used in Europe.
Patients are often taking OTC medicines that they do not tell us about. They either do not remember or do not have a sense of how many OTCs they take for pain relief. It is not unusual for headache sufferers to consume eight to ten ibuprofen or Excedrin on a daily basis; the liver and kidneys may be affected. Triggers One of the primary things we can do is educate patients about triggers. Unfortunately, we cannot do very much about certain triggers, but when a patient has a headache every time the weather changes, or the first day of every menstrual period, we might be able to use medicine the day or night before as a preventative.
Of course, missing meals, under- or oversleeping, bright lights, and certain foods also contribute, but the role of foods tends to be overemphasized. People are given a forbidden-food list and told, “Avoid these foods and you won’t have headaches,” and then they are disappointed. Many books concentrate on diet and foods, but these are low on the list of important triggers. Caffeine, however, is a major trigger. We need to limit the patient’s intake, although the limit varies. Some people can consume 800 mg a day of caffeine and not incur rebound headaches or withdrawal.
Advanced Headache Therapy: Outpatient Strategies by Lawrence Robbins