Headache

A headache in many cases can be a symptom of other underlying issues. In most cases, a headache subsides with the intake of an OTC painkiller or given adequate rest. To pinpoint the exact cause for a recurring, persistent headache, it calls for a detailed history of the patient as a starting point.

A headache is often one of the common symptoms associated with a wide range of ailments, drug interaction or change in weather to hormonal variations. The following list is not exhaustive - but only to suggest as a sample of some possible causes.

Allergic rhinitis - can cause fatigue and headache. Some drugs like alpha blockers cause side effects like drowsiness, tiredness, headache, nervousness, irritability, stuffy or runny nose, nausea, pain in the extremities. Metronidazole drug can also result in headache, nausea and vomiting if taken with alcohol.

Premenstrual Dysphoric Disorder (PMDD) or Premenstrual syndrome (PMS) has symptoms which include abdominal pain, headache, nervousness and irritability along with breast tenderness before menstruation. Antihistamines cause drowsiness and headache as a side effect.
Heat stroke can cause severe head ache, high fever and dry skin.

A cancer in the adrenal medulla known as Pheochromocytoma can cause high blood pressure, headache, palpitations and excessive perspiration.
Cerebral Aneurysms may cause headaches lasting for days or weeks - called as Sentinel Headaches as they are a warning to an impending rupture or Spontaneous Subarachnoid Hemorrhage (SSH).

Migraine Headache refers to the recurrent headache on one side or both sides - often accompanied by nausea or vomiting with episodes of aversion to light.

Cluster Headache is the excruciating pain centered around one eye or temple.

Tension Headache - the common form of headache refers to the dull ache that may appear to exert pressure on the head.

Comparison of Tension Type Headache and Migraine Headache

Diclofenac

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used as a painkiller and anti-inflammatory medication. It is available in various forms, including oral tablets, capsules, topical gels and patches.

Diclofenac primarily works by inhibiting the production of prostaglandins. Prostaglandins are hormone-like substances that are involved in the inflammatory response and play a role in mediating pain, fever and swelling. They are produced in response to tissue injury or inflammation and their release sensitizes pain receptors, leading to the perception of pain and increased blood flow to the affected area. By inhibiting the production of prostaglandins, diclofenac helps to reduce inflammation and relieve pain.

Diclofenac is used as an Analgesic for musculoskeletal inflammatory disorders ranging from Arthritis, Dermatomyositis and Ankylosing Spondylitis. Diclofenac (trade name: Voltaren) is useful for pain management when there is inflammation. As this pain killer is effective in managing inflammation, diclofenac is also available for topical applications - sprain and contusion.

Indications : Diclofenac is primarily used to relieve pain and reduce inflammation associated with conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, and musculoskeletal injuries. It can also be used for postoperative pain management.

Mode of Action : Diclofenac inhibits the activity of cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2, thereby reducing the production of prostaglandins, which are involved in pain and inflammation.

Dosage and Administration : The dosage of diclofenac varies depending on the condition being treated and the formulation used. It is important to follow the prescribed dosage and administration instructions provided by the healthcare professional or as indicated in the product labeling.

Side Effects : Like other NSAIDs, diclofenac may have potential side effects. Common side effects include gastrointestinal symptoms such as stomach pain, indigestion, and nausea. More severe but rare side effects may include gastrointestinal bleeding, liver and kidney problems, and cardiovascular events. It is important to consider individual patient risk factors and monitor for side effects during treatment.

Contraindications and Precautions : Diclofenac is contraindicated in patients with a history of allergic reactions to NSAIDs, aspirin, or other related medications. It should be used with caution in patients with a history of gastrointestinal ulcers, cardiovascular disease, renal impairment, or hepatic dysfunction. Special attention should be given to the elderly and those with certain comorbidities.

Drug Interactions : Diclofenac may interact with other medications, such as anticoagulants, antiplatelet drugs, selective serotonin reuptake inhibitors (SSRIs), and diuretics. It is crucial to review the patient's medication profile and consider potential drug interactions before prescribing diclofenac.

Monitoring: Regular monitoring of patients receiving diclofenac is essential to evaluate the effectiveness of pain management and to assess any potential adverse effects. Close monitoring of renal function, liver enzymes, and blood pressure may be required in certain patients.

Aceclofenac

Aceclofenac is a Non Steroidal Anti-Inflammatory Drug (NSAID) that is commonly used for its analgesic (pain-relieving) and anti-inflammatory properties. It is typically prescribed to treat various conditions such as rheumatoid arthritis, osteoarthritis, ankylosing spondylitis and other inflammatory disorders.

Mechanism of Action : Aceclofenac works by inhibiting the production of prostaglandins, which are substances responsible for pain, swelling, and inflammation. It primarily targets the enzyme cyclooxygenase (COX), specifically COX-2, thereby reducing pain and inflammation.

Indications : Aceclofenac is indicated for the relief of pain and inflammation associated with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and other musculoskeletal disorders. It can also be used to alleviate postoperative pain, dental pain and gynecological pain.

Dosage and Administration : The dosage of aceclofenac may vary depending on the patient's age, condition, and response. It is typically administered orally as tablets or capsules, with or without food. The recommended initial dose for adults is usually 100 mg twice daily. However, it is essential to follow specific dosing instructions provided by the manufacturer or the prescribing physician.

Contraindications and Precautions : Aceclofenac should be avoided in individuals with a history of hypersensitivity or allergic reactions to NSAIDs, including aspirin. It is also contraindicated in patients with active peptic ulcers, severe heart failure, severe renal impairment and bleeding disorders. Caution should be exercised in patients with a history of gastrointestinal disorders, asthma, hypertension, or compromised renal or hepatic function.

Adverse Effects : Common side effects of aceclofenac include gastrointestinal disturbances such as abdominal pain, dyspepsia, nausea, and diarrhea. Less frequently, it may cause dizziness, headache, skin rash, and elevated liver enzymes. Serious adverse effects like gastrointestinal bleeding, peptic ulcers, renal impairment, and allergic reactions can occur but are relatively rare.
Drug Interactions: Aceclofenac can interact with other medications such as anticoagulants, antiplatelet drugs, selective serotonin reuptake inhibitors (SSRIs), diuretics, and certain antihypertensive agents. It is important to evaluate potential drug interactions and adjust the dosage or consider alternative therapies if needed.
Pregnancy and Lactation : Aceclofenac is contraindicated during the third trimester of pregnancy as it may cause harm to the fetus and complications during delivery. It should also be avoided during breastfeeding as it can be excreted in breast milk.

Aceclofenac belongs to the family of nonsteroidal anti-inflammatory drugs (NSAIDs). Other painkillers in this family include:

• Ibuprofen: Ibuprofen is a commonly used NSAID that provides relief from pain, inflammation, and fever. It is available over-the-counter and in higher doses with a prescription.
  
• Diclofenac: Diclofenac is another NSAID used to reduce pain, inflammation, and swelling. It is available in various formulations such as tablets, capsules, gels, and topical patches.
  
• Naproxen: Naproxen is an NSAID used for the relief of pain, swelling, and stiffness caused by various conditions, including arthritis, tendonitis and menstrual cramps.
  
• Indomethacin: Indomethacin is an NSAID prescribed for the treatment of moderate to severe pain, inflammation, and stiffness associated with conditions like arthritis and gout.
  
• Meloxicam: Meloxicam is an NSAID used for the management of pain and inflammation caused by conditions like rheumatoid arthritis and osteoarthritis.
  
• Ketorolac: Ketorolac is an NSAID available in oral and injectable forms, primarily used for short-term management of moderate to severe pain, such as postoperative pain or pain due to kidney stones.
  

It is important to note that while these medications belong to the same family of NSAIDs, they may have varying potencies, dosing regimens, and potential side effects. The choice of painkiller depends on the individual patient's condition, medical history, and the prescribing physician's judgment. It is advisable to consult with a healthcare professional for proper evaluation and selection of the most suitable painkiller.