Marcus Effective Migraine Treatment in Pregnant and Lactating Women: A Practical Guide

A Practical Guide
1. Auflage 2009
ISBN: 978-1-60327-439-5
Verlag: Humana Press
Format: PDF
Kopierschutz: Wasserzeichen (»Systemvoraussetzungen)

E-Book, Englisch, 207 Seiten

More than 28 million Americans suffer from migraine headaches, with migraine affecting nearly one in five women in their reproductive years. Effective Migraine Treatment in Pregnant and Lactating Women: A Practical Guide, provides a comprehensive resource to address diagnosis, testing, and treatment of headaches in reproductively fertile women. This important new book offers a wealth of practical, ready-to-use, clinically tested tips and recommendations to treat women with headaches during pregnancy and nursing. Although women may ideally prefer to restrict migraine treatments during pregnancy, up to one in three pregnant women self-medicate for symptoms, especially with analgesics. Fortunately, there are many effective treatment options that can be safely used when pregnant and breastfeeding. Available therapies include medication and nonmedication treatments, traditional and alternative therapies, and nutritional supplements.This book uniquely answers frequently asked questions by patients and offers healthcare providers easy-to-use office tools for patient education and charting documentation. The authors of this important new work have collaborated to provide a resource that will help clinicians provide women with the tools and knowledge to become empowered and to gain control over their migraines when trying to conceive, during pregnancy, and when nursing.

Autoren/Hrsg.

Marcus, Dawn

Inhaltsverzeichnis

1;Effective Migraine Treatment in Pregnant and Lactating Women: A Practical Guide;2
1.1;Foreword;6
1.2;Preface;7
1.3;Contents;9
1.4;Understanding Migraine and Pregnancy;13
1.4.1;Typical Concerns Your Patient May Have;17
1.4.2;Summary;37
1.4.3;References;37
1.5;Safety Rating Systems for Drugs Used in Pregnancy and Lactation;41
1.5.1;Pregnancy;42
1.5.1.1;Medication Use During Pregnancy;42
1.5.1.2; Understanding Reproductive Risk;45
1.5.1.3;Tools for Assessing Reproductive Risk;45
1.5.2;Lactation;48
1.5.2.1; Trends in Breastfeeding;49
1.5.2.2; Maternal Drug Effects on the Baby;50
1.5.3;Helpful Online and Print Resources;53
1.5.4;Summary;56
1.5.5;References;56
1.6;Non-Pharmacological Headache Treatments;58
1.6.1;Trigger Identification and Avoidance;61
1.6.1.1;Cause or Coincidence?;61
1.6.1.1.1;Dietary Recommendations During Pregnancy and Lactation;63
1.6.1.2;Trigger Avoidance or Desensitization?;63
1.6.2;Psychological Pain Management Skills;64
1.6.2.1;Relaxation and Biofeedback;64
1.6.2.1.1;Relaxation During Pregnancy and Lactation;65
1.6.2.2;Stress Management;66
1.6.2.3;Cognitive Restructuring;67
1.6.2.4;Distraction;68
1.6.2.5;Effective Psychological Pain Management Technique Delivery Systems;69
1.6.3;Healthy Lifestyle Habits;70
1.6.3.1;Diet;70
1.6.3.2;Sleep;71
1.6.3.2.1;Physiology of Sleep and Headache;71
1.6.3.2.2;Effect of Sleep Disturbance on Headache;72
1.6.3.2.3;Sleep and Pregnancy;73
1.6.3.3;Smoking;74
1.6.3.3.1;Smoking and pregnancy;74
1.6.4;Exercise and Physical Therapy;75
1.6.4.1;Aerobic Exercise;75
1.6.4.2;Stretching Exercises;76
1.6.4.3;Intraoral Appliances;76
1.6.5;Massage and Other Manual Therapies;77
1.6.6;Summary;77
1.6.7;References;78
1.7;Acute Treatment Options for the Pregnant Headache Patient;82
1.7.1;Design Safer Treatment Plans Before Conception;85
1.7.2;Develop a Safer and Effective Acute Treatment Plan;86
1.7.2.1;Don’t Medicate Mild Headaches;87
1.7.2.2; Treat Nausea Aggressively;88
1.7.2.2.1; Non-drug Treatments;88
1.7.2.2.2;Anti-emetic Medications;89
1.7.2.2.3;Herbs and Supplements;89
1.7.2.2.4;Determining First-Line Treatment of Migraine-Related Nausea During Pregnancy;91
1.7.2.3;Maximize Non-drug Treatments;93
1.7.2.3.1;Treat Co-existing Temporomandibular Dysfunction;94
1.7.2.3.2;Effectively Implementing Non-drug Treatments;94
1.7.2.4;Select the Safest Effective Medications;95
1.7.2.4.1;OTC Medications;96
1.7.2.4.2;Prescription Medications;98
1.7.2.4.3;Herbal Remedies;102
1.7.2.4.4;Determining First-Line Migraine Medication Treatment;102
1.7.3;Effectively Communicating Medication Advice;103
1.7.4;Regularly Assess Treatment Efficacy;105
1.7.4.1;Scheduling Follow-Up Visits;107
1.7.5;Summary;108
1.7.6;References;109
1.8;Acute Treatment Options for the Lactating Headache Patient;112
1.8.1;Consider Important Secondary Causes of Headache;113
1.8.2;Anticipate Headache Recurrence After Delivery;117
1.8.2.1;Utilize Good Principles of Acute Headache Treatment;119
1.8.2.2;Select the Safest Medications;119
1.8.2.3;Time Maternal Medication Dosing;120
1.8.2.4; Specific Medication Recommendations;121
1.8.2.4.1;Analgesics;121
1.8.2.4.2;Triptans;124
1.8.2.4.3;Rescue Therapy;124
1.8.2.4.4;Anti-emetics;125
1.8.2.4.5;Herbal Remedies;125
1.8.3;Summary;125
1.8.4;References;126
1.9;Preventive Treatment Options for the Pregnant Headache Patient;128
1.9.1;Identify Patients Needing Preventive Therapy;130
1.9.2;Provide Safe and Effective Prevention Recommendations;131
1.9.2.1;Consider Possible Future Pregnancy When Using Prevention in Non-pregnant Patients;132
1.9.2.2;Maximize Safe and Effective Non-medication Treatments;132
1.9.2.3;Utilize Medications in Select, Difficult-to-treat Patients;133
1.9.2.3.1;Don’t Permit Analgesic Overuse in Patients Needing Prevention;135
1.9.2.3.2;Limit Preventive Medication Exposure;137
1.9.2.3.3;Antihypertensives;138
1.9.2.3.4;Antiepileptics;139
1.9.2.3.5;Antidepressants;140
1.9.2.3.6;Injections and Alternative Therapies;141
1.9.2.3.7;Vitamins, Herbs, and Supplements;143
1.9.2.3.8;Summarizing Medication Recommendations;144
1.9.3;Summary;145
1.9.4;References;145
1.10;Preventive Treatment Options for the Lactating Headache Patient;148
1.10.1;Plan for Headache Recurrence After Delivery;150
1.10.1.1;Include Plans for Contraception;150
1.10.2;Develop a Safe and Effective Preventive Treatment Plan;151
1.10.2.1;Maximize Effective Non-medication Treatments;151
1.10.2.2;Select Safe Medications;151
1.10.2.2.1;Antihypertensives;152
1.10.2.2.2;Antiepileptics;153
1.10.2.2.3;Antidepressants;153
1.10.2.2.4;Muscle Relaxants;154
1.10.2.2.5;Vitamins and Minerals;154
1.10.2.2.6;Summarizing Preventive Medication Recommendations;155
1.10.2.3;Time Drug Administration to Minimize Effects;155
1.10.3;Summary;156
1.10.4;References;156
1.11;Urgent Care/Emergency Treatment of the Acute, Severe Headache in Pregnant and Lactating Patients;158
1.11.1; Utilize a Consistent Evaluation and Treatment Plan;162
1.11.2;Rule Out Secondary Causes of Headache;162
1.11.3;Treat Dehydration;163
1.11.4;Treat Nausea Aggressively;164
1.11.5;Always Consider Non-medication Treatments;166
1.11.6;Treat Pain Appropriately;167
1.11.7;Consider Trigger Point Injections or Occipital Blocks;169
1.11.8;Arrange Post-ED Follow-up;170
1.11.9;Summary;173
1.11.10;References;174
1.12;Work-up for Headache During Pregnancy and Lactation;177
1.12.1;Headache History;178
1.12.1.1;Red Flags/Alarm Symptoms;180
1.12.2;Physical Examination;181
1.12.2.1;Spinal Fluid Examination;183
1.12.2.2;Neuroimaging;184
1.12.2.2.1;Computed Tomography;186
1.12.2.2.2;Magnetic Resonance Imaging;187
1.12.2.2.3;Contrast Agents During Pregnancy;187
1.12.2.2.4;Contrast Agents During Lactation;188
1.12.3;Summary;188
1.12.4;References;189
1.13;Patient Headache Resources;191
1.13.1;References;193
1.13.2;General Information;194
1.13.2.1;When you’re ready to get pregnant hellip;194
1.13.2.2;Now that you’re pregnant hellip;195
1.13.2.3;After you’ve delivered hellip;196
1.13.3;Headache Treatment;198
1.13.3.1;Now that I’m trying to get pregnant, what can I do when I get a headache?;198
1.13.3.2;What non-drug treatments are effective for treating headaches?;200
1.13.3.3;Practicing relaxation techniques;203
1.13.3.4;Tips for performing relaxation techniques;203
1.13.3.5;Stress management;205
1.13.3.6;Headache-reducing exercises;207
1.13.4;Nausea Treatment;209
1.13.4.1;What can I do if I’m feeling nauseated during my pregnancy?;209
1.13.5;Additional Headache Resources;210
1.13.5.1;Where can I find reliable online information about migraine and other headaches?;210
1.13.5.2;Where can I learn more about managing headaches?;211
1.14;Index;213