Fibromyalgia Flashcards
What is Fibromyalgia?
Widespread musculoskeletal pain with no cause identified
Not associated with tissue inflammation
Pain possibly a result of damage or abnormal functioning of the PNS and/or CNS
What is Centralized pain disorder as it relates to the cause of Fibromyalgia?
Characterized by disturbance in CNS pain processing
Patients with Fibromyalgia often experience what kind of false stimuli?
noxious (harmful) stimuli
heat, electrical current, or pressure
painful at lower levels of physical stimulation
What are the first recommended steps to treat Fibromyalgia?
Trial with low-dose tricyclic antidepressants or selected antidepressants or anticonvulsants proven effective in fibromyalgia
Exercise program
What treatments do improve Fibromyalgia?
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MOA of Tricyclic antidepressant Amytriptiline and Despiramine?
TCA-blockade of NET and SERT channels
ADE of Amytriptiline and Despiramine?
dry mouth constipation fluid retention, weight gain, grogginess, difficulty concentrating are common
MOA of Cyclobenzaprine
Centrally acting skeletal muscle relaxant pharmacologically related to TCAs
ADE of Cyclobenzaprine?
Drowsiness, xerostomia, change in mental acuity, constipation, neuromuscular skeletal weakness, blurred vision
What medications are used to treat Fibromyalgia?
Amitriptyline Cyclobenzaprine Duloxetine (Cymbalta) Milnacipran (Savella) Gabapentin Pregabalin (Lyrica)
MOA of Duloxetine
Serotinin Reputake Inhibitor (SNRI)
Which patients should Amytriptiline be avoided in?
Older patients side effects and possible cardiotoxicity
MOA of Milnacipran & Venlafaxine
SNRI
What is an ADE of Milnacipran & Venlafaxine
nausea,
headache,
constipation
MOA of Anticonvulsants-Gabapentin
cellular calcium channels
exert their analgesic effects by blocking the release of various neurotransmitters
