PHARMA TX

Question 1

anticonvulsant
MOA not completely understood
blocks calcium conduction at nerve cell membrane
1-2+ weeks to take effect

Answer 1

gabapentin (neurontin)

Question 2

FDA approved 2005
GABA analogue
onset within a week of use

Answer 2

pregablin

Question 3

amitriptyline (Elavil)
nortriptyline (Aventyl)
not FDA indicated for neuropathy
blocks sodium channels and may block NDMA receptors

Answer 3

tricyclic antidepressants

Question 4

first FDA approved medication approved to treat diabetic neuropathic pain

selectively inhibits reuptake of serotonin and norepinephrine

Answer 4

duloxetine (cymbalta)

Question 5

selectively blocks reuptake of serotonin and norepinephrine

Answer 5

venlafaxine (effexor)

Question 6

synthetic opiate
-controlled substance

MOA
-Mu receptor binding to block pain perception

-blocks monoamine transporter reuptake at nerve cell junction (similar to TCA)

Answer 6

Tramadol (ultram)

Question 7

4% patch OTC, 5% patch
topical analgesic
intact skin only

Answer 7

lidocaine patch (lidoderm)

Question 8

FDA approved for neuralgia
analgesic
depletes substance P in sensory nerves, pain mediator in unmyelinated type-c neuron

burns as released, 4-6 hr duration

Answer 8

capsaicin

Question 9

0.25% menthol gel
inhibits calcium currents of neuronal membranes
sensation of coolness
apply frequently, little side effects

Answer 9

biofreeze

Question 10

initial tx for muscle pain or inflammation (30 day supply)

prices vary

Answer 10

compound cream

Question 11

other examples?

Answer 11

NSAIDs

opiates

Question 12

nutritional supplements?

Answer 12

evening primrose oil
acetyl-l-carnitine
alpha lipoic acid
taurine
metanx
magnesium
myo-inositol
succinic acid
dehydroepiandrosterone
L-argenine
benfotiamine