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Itchy, Tiny Bumps All Over - Page 5 - Better Medicine Forums.Body rash or skin rash is an inflammation on the skin and cause itching.
Secondary Causes of Constipation Medicines which contribute to constipation – Antacids containing aluminium or calcium – Amiodarone – Anticholinergics e.g. Constipation Management Individualised according to resident’s needs – Type of constipation Acute or chronic constipation Specialised bowel management e.g. Assessment when constipation suspected Oral examination – check for oral thrush, dehydration Physical examination of abdomen – listen for bowel sounds Rectal examination – Rectum empty and collapses: functioning bowel, no further action, continue daily assessment – Rectum empty and dilated: gross constipation? Learnings Which if the following diseases may increase a resident’s risk of experiencing constipation? Cluster headache is a primary neurovascular disorder, which is characterized by sever unilateral headache. Cluster term refers to the disease pattern characterized by an agglomeration of attacks that occur in a dense succession of time and then suddenly disappear for varying periods of time. Average frequency of painful attacks is 1 to 3 per day, but the number of attacks may increase to 15. Painful access suddenly starts and have a duration between 10 and 45 minutes, but most often lasts between 1 and 2 hours.
The pain is severe, constant, tenacious and is described as excruciating, stabbing, sharp and lancinating. Treatment in cluster headache aims a rapid control of acute attacks and prophylaxis to suppress attacks. Verapamil is considered the drug of choice for pain prophylaxis and the most notable side effect is constipation.


Other therapeutic options are represented by cocaine hydrochloride 5% administered intranasally, or 4% lidocaine solution, acting specifically on sfenopalatine ganglion. Oxygen inhalation is considered the most effective method in aborting cluster headache crisis, 70% of attacks being aborted in 10 minutes and 90% within 20 minutes. In the chronic form of cluster headache, without remissions, are used for prophylaxis ergotamine and methysergid. Gamma-knife radiosurgery represents a less invasive procedure for cluster headache but is associated with an increased risk for facial sensory disturbances. Deep brain stimulation with implantation of stimulating electrodes under stereotactic guidance into the ipsilateral posterior inferior hypothalamus is also a potential option for refractory cluster headache. Doctors, scientists and patients have described the pain from cluster headache as the most intense pain a human can endure, worse than child birth or a broken bone. For a period of time, it was considered that the disease belongs to the class of vascular migraines, but the International Headache Society (IHS) reclassified cluster headache as a single entity, different from migraine.
Recent studies suggest that in cluster headache pathogenesis, genetic factors are involved. An active disease cycle may last between 4 and 8 weeks, but it varies from patient to patient. In most cases, the pain is limited to a localized area around one eye or periorbital, retroorbital, or in temporal region, accompanied by a state of agitation in which the patients do not like to lie down to rest; instead, they are restless and prefer to pace or move around.
Pain during the attack reaches a very high intensity, so oral agents are too slow to be effective. Sleep attacks can be prevented by administrating 1 mg of ergotamine tartrate with one hour before badtime.


Lithium carbonate administered 2 or 3 times per day is effective in 70% -80% of cases and present as side effects gastrointestinal disturbances, tremor, confusion and weight loss. Methysergid is mainly used in cluster headache with attacks that are lasting less than three months. Surgical procedures such as invasive nerve blocks and ablative neurosurgical procedures (percutaneous radiofrequency, trigeminal gangliorhizolysis, rhizotomy) all have been implemented successfully.
Is an invasive procedure and is associated with significant risk of complications such as intracranial hemorrhage, subcutaneous infection, micturition syncope, and transient loss of consciousness. During crises, alcohol consumption, vasodilators and histamine administered subcutaneously aggravate cluster headache attacks. Painful attacks are accompanied by autonomic phenomena like unilateral lacrimation, rhinorrhea or nasal obstruction, nasal congestion, conjunctival congestion, and rarely flush, nausea and vomiting. The drug of choice remains dihydroergotamine, administered once or twice daily intramuscular or subcutaneous. Vegetative phenomena may occur before pain and scalp and facial skin are hyperalgal in most cases.



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    08.02.2016

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