Which medications in the drug class Analgesics, Other are used in the treatment of Pediatric Headache?

Updated: Jan 02, 2019
  • Author: J Ivan Lopez, MD, FAAN, FAHS; Chief Editor: George I Jallo, MD  more...
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Analgesics, Other

Analgesics are indicated for the treatment of mild to moderate pain and headache. They are the mainstays of headache treatment. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients in pain.

Aspirin (Bayer Aspirin, Ecotrin, Tri-Buffered Aspirin)

Aspirin is used to treat mild to moderate pain. It inhibits prostaglandin synthesis, which prevents the formation of platelet-aggregating thromboxane A2.

Acetaminophen (Tylenol, FeverAll, Acephen, Little Fevers, Mapap)

Acetaminophen is the drug of choice for pain in patients with documented hypersensitivity to aspirin or NSAIDs, upper GI disease, or current oral anticoagulant use.

It can be used for symptomatic relief in migraine and tension-type headaches, although its efficacy in relieving tension-type headache is modest. Acetaminophen is fairly effective in migraine attack termination, especially when it is combined with an antiemetic.

Combinations with pseudoephedrine (Sudafed) or caffeine (Excedrin Migraine) can be considered but should not be used regularly short of a risk of rebound withdrawal headache.

Acetaminophen 15 mg/kg was slightly less effective than ibuprofen 10 mg/kg at 2 hours, but was equally effective at 1 hour, in a randomized, controlled trial by Hamalainen et al. There were no serious adverse events. [58]

Morphine (Duramorph, Avinza, Kadian, MS Contin, Oramorph)

Morphine is the drug of choice for analgesia because of its reliable and predictable effects, safety profile, and ease of reversibility with naloxone. It is the most potent of the opiate agonists and is useful for the acute management of headache due to migraine. Various IV doses are used and are commonly titrated until the desired effect is obtained. Its use is cautioned in conditions with raised intracranial pressure. Opiates should be used with a great deal of caution in the pediatric population.

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