medication-overuse+headache

=Medication-overuse headache=

//A man walks into your pharmacy, enquiring about a headache.//

Problem
Being able to distinguish medication-overuse headache with other types of headache. Also to give appropriate treatment.

Questions to Ask
- How long have you had your headache? - Is the headache always present, often presents upon waking? - What medications are you taking? //the patient may be taking analgesics for other reasons (e.g. back pain)// - Do you take medication daily or nearly every day for headache? //simple analgesics >15 days/month, combination analgesics >10 days/month (Mersyndol or Panadeine)// - Does the headache occur on more than half the days in the month?

What to do
- confirm medication-overuse headache - work out what analgesic medications they are taking, and for how long - possibly reduce severity of analgesia (remove codeine in combination products) - may need to refer, as analgesics need to be withdrawn slowly