Pain- Topical Analgesics

Question 1

Topicals used in pain

Answer 1

Capsaicin and lidocaine

Question 2

Capsaicin indications

Answer 2

PDN, PHN

Question 3

Lidocaine indications

Answer 3

PDN, PHN

Question 4

Capsaicin MoA

Answer 4

Depletes and prevents reaccumulation of substance P in the peripheral sensory neurons

(caPsaicin, Prevents substance P from accumulating in the Peripheral sensory neurons)

Question 5

Pros of capsaicin

Answer 5

Can use long-term

Question 6

Con of capsaicin

Answer 6

Has application issues- be careful with handling and don’t make eye contact with it

Question 7

Formulations of capsaicin

Answer 7

8% patch
0.025% patch
Zostrix neuropathy 0.25% topical cream
Capsaicin topical cream (0.025-0.1%)

Question 8

Counseling point for the 8% capsaicin patch

Answer 8

Pretreat with a local anesthetic to the treatment area and another 1-2cm of surrounding area

Use up to 4 patches/application, leave on for 60 minutes and repeat no more frequently than q3m PRN

Question 9

Pro of lidocaine

Answer 9

Quick onset (5-10 minutes)

Question 10

Con of lidocaine

Answer 10

Variable duration

Question 11

Formulations of lidocaine available

Answer 11

5% patch, 2% viscous solution- Rx
up to 4% strength available OTC
ZTildo: 1.8% patch

Question 12

Topical anesthetics are good in what patients?

Answer 12

Elderly (as long as they have a specific spot where the pain is occurring to put the patch/cream/other topical product on)