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When assessing a patient who is experiencing headache for the first time, MTM providers should ask appropriate questions to determine the type of headache (eg, tension or migraine).
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MTM providers should assess whether a patient has underlying conditions that may contribute to headache, and refer patients for whom headache may be a symptom of a more serious problem (eg, severely elevated blood pressure).
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When possible, MTM providers should encourage patients experiencing moderate to severe migraine to take migraine-specific medications, such as a triptan, for relief of pain. These are more effective than analgesic pain relievers for migraine headache.
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MTM providers should educate patients taking triptans to take these agents as soon as possible at the start of migraine pain for maximal effect.
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MTM providers should stay alert for patients who have frequent, very severe, or long-lasting migraine headaches. These patients may benefit from preventive therapy to decrease migraine frequency or severity.
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INTRODUCTION TO HEADACHE
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Headache is a pain that arises from either the neck or head. Headaches are generally classified as being 1 of 3 types: migraine, tension, or cluster. These types can be subdivided further, and each type has defined treatment options. Information presented in this chapter will focus on migraine treatment, because this headache type has a significant number of pharmacotherapy treatment options and is encountered relatively frequently in practice (Table 24-1).
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