UMEM Educational Pearls

Category: Neurology

Title: All this is giving me a headache!

Keywords: analgesia, headache, opioids (PubMed Search)

Posted: 6/26/2019 by Danya Khoujah, MBBS
Click here to contact Danya Khoujah, MBBS

Primary headaches (not secondary to a life-threatening disease) can be challenging to manage. Remember the following pearls:

  • Things that DO NOT work: IV fluids, 5-HT3 Antagonists (aka Zofran), diphenhydramine (aka Benadryl), opioids

  • Things that KINDA work: oxygen for all headaches, sphenopalatine ganglion block (4% lido spray) 

  • Things that REALLY work: ketorolac, metoclopramide, prochlorperazine, triptans and ergots, oxygen for cluster headaches
  • Things that PREVENT recurrence: dexamethasone for migraine headaches