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Questions and Answers
What is the primary mechanism of action of acetaminophen?
What is the duration of activity of acetaminophen?
What is the primary effect of acetaminophen on pain?
What is a potential trigger of migraine that patients should avoid?
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What is a nutritional strategy for preventing migraine?
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What is a common food allergy that may trigger migraine?
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What is a vasoactive substance that may trigger migraine?
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What is the recommended strategy for managing stress to prevent migraine?
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What is the precaution when using salicylates and NSAIDs with high-dose methotrexate therapy?
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What is the effect of salicylates on sulfonylureas?
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What is the role of caffeine in combination products?
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What type of patient should avoid self-treatment with nonprescription analgesics?
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What is a recommendation for pediatric patients regarding acetaminophen products?
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What is the indication for children ages 6 months to 2 years in new label directions?
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What is a characteristic of patients who are intolerant to aspirin?
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What type of combination products are available for sinus headaches or other indications?
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What is the effect of salicylates and NSAIDs on antihypertensive agents?
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Which of the following medications may increase the risk of bleeding when used with salicylates and NSAIDs?
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What is the potential effect of salicylates and NSAIDs on potassium levels?
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Which of the following medications may be affected by the concurrent use of salicylates and NSAIDs?
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What is the recommended management strategy for patients taking salicylates and NSAIDs with anticoagulants?
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What is the potential effect of concurrent use of salicylates and NSAIDs with alcohol?
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Which of the following salicylates may have a lower risk of bleeding when used with anticoagulants?
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What should be monitored in patients taking salicylates and NSAIDs with potassium-sparing diuretics and ACE inhibitors?
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Study Notes
Nonpharmacologic Therapy for Migraines
- Maintaining regular sleeping, eating, and exercise schedules is a key part of general treatment measures for migraine
- Stress management, biofeedback, and cognitive therapy are also important nonpharmacologic therapies for migraine
- Applying ice or cold packs combined with pressure to the forehead or temple areas can reduce pain associated with acute migraine attacks
Nutritional Strategies for Migraines
- Dietary restriction of foods that contain triggers is a key part of nutritional strategies for preventing migraine
- Avoiding hunger and low blood glucose is also important, as it can trigger migraine
- Magnesium supplementation is recommended as part of nutritional strategies for preventing migraine
- Avoiding foods with vasoactive substances, such as:
- Tyramine (found in red wine and aged cheese)
- Phenylalanine (found in aspartame)
- Monosodium glutamate (often found in Asian food)
- Caffeine
- Theobromines (found in chocolate)
Pharmacologic Therapy - Acetaminophen
- Acetaminophen is an effective analgesic and antipyretic
- It produces analgesia through central inhibition of prostaglandin synthesis
- Acetaminophen is rapidly absorbed from the gastrointestinal tract and extensively metabolized in the liver
- Duration of activity is about 4 hours, but can be increased to 6-8 hours with an extended release formulation
- Acetaminophen is effective in relieving mild-moderate pain of non-visceral origin
Acetaminophen - Contraindications and Interactions
- Recent changes have been implemented to decrease pediatric dosing errors with liquid acetaminophen formulations
- Acetaminophen should be avoided with high-dose methotrexate therapy, and blood glucose levels should be monitored
- Salicylates and NSAIDs should be avoided with high-dose methotrexate therapy, and blood glucose levels should be monitored
Combination Products
- Many nonprescription analgesics are available in combination products
- Caffeine is used as an adjunct to analgesics for tension type and migraine headaches
- Combination dosage forms containing a decongestant and either acetaminophen or an NSAID are also available
Patient Factors
- For pediatric patients, a single concentration for solid dose, single ingredient acetaminophen products is recommended
- Weight-based dosing for children ages 2-12 is also recommended
- Patients with significant alcohol ingestion should avoid self-treatment with nonprescription analgesics
- Patients who are intolerant to aspirin may cross-react with other chemicals or drugs
Patient Factors - Cont
- Antihypertensive effect may be inhibited by salicylates and NSAIDs, and hyperkalemia may occur with potassium-sparing diuretics and ACE inhibitors
- Patients should monitor blood pressure, cardiac function, and potassium levels
Clinically Important Drug-Drug Interactions with Nonprescription Analgesic Agents
- Salicylates and NSAIDs may increase the risk of bleeding, especially GI bleeding, when used with anticoagulants
- Salicylates and NSAIDs may increase the risk of GI bleeding when used with alcohol
- Salicylates and NSAIDs may interact with antihypertensive agents, beta blockers, ACE inhibitors, vasodilators, and diuretics, and may inhibit their antihypertensive effect
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Description
Learn about non-pharmacologic therapy and nutritional strategies for managing migraines, including maintaining regular schedules, stress management, and dietary restrictions.
