Chronic Pain Flashcards
Symptoms of neuropathic pain
burning, tingling sensations, shock-like/shooting, increased painful response, hypersensitivity to touch/cold
1st line treatment or TRIGEMINAL NEURALGIA
carbamazepine
1st line tx for ACUTE PERIPHERAL NEUROPATHIC PAIN (post-herpetic neuralgia)
amitriptyline
gabapentin
pregabalin
1st line tx for CHRONIC PERIPHERAL NEUROPATHIC PAIN
TCA
gaba/pregab
1st line tx for diabetic neuralgia
gabapentin
pregabalin
TCA
venlafaxine
duloxetine
causes of neuropathic pain
abnormalities in the nerves, spinal cord, and brain
carbamazepine dosing for trigeminal neuralgia
optimal: 200-800 mg daily
max: 1200 mg daily
first line tx for bells palsy
- prednisone 60 mg x 5 days
+
antiviral - start within 72 hrs
in bells palsy, what should be an important counselling tip to patients regarding the eyes?
tape eyelid closed at night, lubricate with eyedrops, protect with glasses during the day since blinking is difficult
1st line drug for chronic spasticity
baclofen
1st line drug for nerve root compression
NSAIDs and/or acetaminophen during the acute phase
1st line drug for fibromyalgia
duloxetine
pregabalin
1st line for chronic fatigue syndrome
non-pharm measures
1st line drug for polymyalgia rheumatica and giant cell arteritis
prednisolone 10-20 mg/day
1st line for whiplash/neck pain
NSAIDs
alternative drug for whiplash
amitriptyline for sedation
which drugs should be avoided with gabapentin due to DDI?
antacids
opioids (sedation)
which drug can cause peripheral edema?
pregabalin
what are the withdrawal symptoms of pregabalin?
nausea
insomnia
sweating
pain
diarrhea
which opioid is commonly used as 2nd line therapy for chronic nerve pain?
tramadol 50-100 mg q4-6 hrs
What is the therapeutic advantage of antiviral treatment in post-herpetic neuralgia?
decreases the duration of pain
What is a 2nd line option for post-herpetic neuralgia?
lidocaine patch 5%
What is the appropriate dosing of acyclovir in post-herpetic nuralgia?
acyclovir 800 mg 5 times daily x 7 days
