ANS WEEK 25 CNS OTC 1,2 & 3 PDF

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Summary

WEEK 25: CNS OTC 1,2 & 3 Migraine: ➢ episodic headache ➢ associated with symptoms of photophobia2.Migraine with aura: Migraine without aura:● With neurological symptoms(more in stages of migraine Q)● Absence of neurological symptoms ● No-prodromal phase ● Both sides of head may be affect...

Description

WEEK 25: CNS OTC 1,2 & 3 1. Migraine: ➢ episodic headache ➢ associated with symptoms of photophobia 2. Migraine with aura: ● With neurological symptoms (more in stages of migraine Q.3)

Migraine without aura: ● ● ● ●

Absence of neurological symptoms No-prodromal phase Both sides of head may be affected GI symptoms may occur

3. Factors causing migraine: ➢ ➢ ➢ ➢ ➢

Diet Hormones Physical Environmental Psychological

4. Stages of migraine and their symptoms Prodromal symptoms

Aura symptoms (last 4 hrs on >15 days per month Sinusitis : ➢ Result of inflammation/swelling of the mucosal lining Features of sinusitis: ➢ ➢ ➢ ➢

Secondary infection develops Pressure buildup which causes pain Usually unilateral. Behind and around eye Worse on bending forwards or lying down.

RED FLAGS/REFERRAL FOR CNS PAIN: Migraine with OC Frequent migraine Severe headache of >4 hrs duration Suspected ADR Suspected meningitis ○ Neck stiffness ○ Visual disturbance ➢ Associated with injury/trauma ➢ Children under 12 years

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MUSCULOSKELETAL PAIN: 1. Causes of musculoskeletal pain ➢ Inflammation ➢ Trauma/injury ➢ Mechanical 2. Differentiate between RA and OA? RA

OA

Definition

● Inflammation of synovial lining of peripheral joint

● Inflammation of articular cartilage and bone of peripheral and spinal joint

Symptoms

● Starts at any age ● Polyarthritis ● Affects on other systems eg eyes ● Joint pain;can be extreme ● Swellin ● Prolonged morning stiffness

Over age of 55 yrs Monoarticular Joint pain Stiffness after prolonged rest ● Functional impairment

OTC Treatment

● ● ● ● ●

Counsellings

● Support to adapt disability ● Avoid overuse of

Simple analgesic NSAIDs Topical formulations Fish oils Oil of evening primrose

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● ● ● ● ●

Simple analgesics NSAIDs Topical formulation Glucosamine 1500mg/day Chondroitin 1200mg/day

● Joint protection ● Weight loss ● Keep active

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analgesics ● Caution with NSAIDs ● Advice about DMARDS, cytotoxic , corticosteroids ● Information about corticosteroid injections

● physiotherapy

3. Bursitis: ➢ Inflammation of bursa (sacs of fluid protecting adjacent structures) 4. Bursitis be treated with : ➢ Rest and cooling, and then after 48 hrs apply heat. ➢ If this does not help refer 5. Features of fibritis?

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SALTI with no abnorm Stiffness Aching at multiple sites Lethargy Tension headaches IBS With no abnormalities

6. Duration of avoiding activity following sprain/strain: ➢ 2-3 days 7. Duration of kept for the injury ➢ 15-20mins every 2-3 hours 8. Duration: ➢ of compression:2-3 days ➢ of elevation: first 2 days

9. Avoid HARM durations: ➢ First 3 days

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10.Duration of avoiding NSAIDS during injury and why ➢ For the first 2 days after the injury ➢ Because they may delay healing 11.Whiplash ➢ A neck injury ➢ Caused by a sudden movement of the head forwards, backwards or sideways 12.Symptoms of whiplash ➢ Neck pain and stiffness ➢ tenderness/reduced,painful neck movements ➢ Headaches ➢ Symptoms can be delayed- (6-12 hours) post event. 13.Treatments for whiplash ➢ Head and neck straight initially ➢ Early mobilisation ➢ Sleep with rolled towel in neck crease ➢ Analgesics 14.Signs of repetitive strain injury ➢ Pain in all./ part of one/both arms ➢ Swelling on back of forearm ➢ Creaking wrist ➢ Work related 15.Signs of carpal tunnel syndrome ➢ Commonest cause of hand pain ➢ Fluid retention ➢ Symptoms of RA ➢ Numbness and tingling ➢ Sense of swelling ➢ Wrist splint at night Treatment : Corticosteroid injecting / surgery required 16.Red Flags/ refer for musculoskeletal conditions ➢ Arthritis

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Back pain associated with abnormal urination Back pain radiating to leg Suspected fracture Head injury Treatment failure Adverse drug reaction

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