Chronic Pain Rx Flashcards
name a few Non-pharmacological intervention ?
Application of heat and cold
TENS
X Pregnancy
X Pacemakers
Adverse effect = skin hypersensitivity
Acupuncture
Massage
Hypnosis
Rx for chronic pain ?
Paracetamol/NSAID + opiate
Why may giving codeing be pointless to some patients ?
Codeine
= Little use unless can be metabolised to morphine
= Abuse potential
Other agents used in treatment of chronic pain ?
Antidepressants
Anticonvulsants
Antiarrhythmic drugs
Steroid injection and trigger points injections
Clonidine
Membrane stabilizers
Ketamine
Calcitonin / Bisphosphonates
MOA of Antidepressants ?
Increase the synaptic concentration of serotonin and/or norepinephrine
in the CNS
by inhibiting their reuptake by the presynaptic neuronal membrane.
MOA of Amitriptyline ?
Antidepressants
Analgesic for certain
chronic & neuropathic pain
True or false ?
Nortriptyline is used in chronic pain.
Antidepressants
True
MOA of Duloxetine ?
Potent inhibitor of neuronal serotonin and norepinephrine reuptake
Indication of Duloxetine ?
diabetic peripheral neuropathic pain
Venlafaxine advantages ?
decrease pain in neuropathic pain
& help with sleep and other mood disorders.
Which Anticonvulsants is approved for neuropathic pain associated with diabetic peripheral neuropathy ?
Pregabalin
Indication of Membrane stabilizers ?
neuropathic pain
Indication of Calcitonin / Bisphosphonates ?
phantom limb pains
