Adjuvant and Topical Analgesics

Question 1

What types of pain do TCAs treat?

Answer 1

Amitriptyline, nortriptyline
Neuropathic pain
Diabetic neuropathy, postherpetic neuralgia, polyneuropathy, and nerve injury or infiltration with cancer
(may also treat underlying depression/insomnia)

Question 2

Venlafaxine (Effexor) treats what types of pain?

Answer 2

(antidepressant)

Neuropathic pain, HA, fibromyalgia, postmasectomy pain

Question 3

Duloxetine(Cymbalta) is prescribed for what type of pain management?

Answer 3

(antidepressant)

Neuropathic

Question 4

Which anticonvulsants can also be used for neuropathic pain?

Answer 4

Gabapentin(Neurotin)
Pregabalin (Lyrica)
(both treat diabetic neuropathy, postherpetic neuralgia, and Pregablin treats fibromyalgia)
Carbamazepine (Tegretol)-trigeminal neuralgia
Phenytoin (Dilantin), Sodium Valproate (Depakote)
Clonazepam (Klonopin), Topiramate (Topamax)
Lamotrigine (Lamictal)

Question 5

Which drugs can be used as an analgesic for cancer and post operative pain and reduces N/V?

Answer 5

Hydroxyzine

IV/IM

Question 6

Which drugs used in inflammatory diseases can also be used for tumor infiltration of nerves?

Answer 6

Corticosteroids

Question 7

Which patients should not be prescribed a clonidine patch?

Answer 7

Hypotensive patients (d/t sympathetic NS invovlement= this is how it modulates pain)

Question 8

Topical analgesics include:

Answer 8

5% lidocaine- postherpetic neuralgia
Lidocaine/prilocaine (EMLA)- cutaneous anesthesia
Topical steroids
Capsaicin cream (Zostrix)- neuropathic/austioarthritic