Fibromyalgia (Marshall) Flashcards Preview

Musculoskeletal Disorders and Pain Management > Fibromyalgia (Marshall) > Flashcards

Flashcards in Fibromyalgia (Marshall) Deck (25):
1

What does fibromyalgia mean?

fibro=tissue
my=muscle
algia= pain

2

T/F Fibromyalgia is a chronic syndrome SOMATIC and PSYCHOLOGICAL symptoms

TRUE

3

T/F The etiology and pathogenesis of fibromyalgia syndrome IS NOT CLEAR and is centered in the MUSCULOSKELETAL SYSTEM

False; centered in the CNS

4

Patients with fibromyalgia have decreased _____ and _______ pain sensitivity

neurotransmitters (dopamine, serotonin, NE); increased

5

What is the cardinal symptom of FMS?

wide-spread NON-inflammatory pain

6

What are 5 predisposing facts for FM/FMS?

-genetic and familial predisposition
-sleep abnormalities
-autonomic nervous system dysfunction
-physical factors (i.e. infection)
-psychological factors (i.e. stress)

7

Pathogenetic mechanism of FMS:
neural processes (3)

-altered heat and cold thresholds
-alternated connectivity in the brain inhibitory network
-reduced tolerance for pain

8

TARGET TO TREAT STRATEGY:
Is FM/FMS a clearly defined condition?

YES

9

TARGET TO TREAT STRATEGY
Can FM be prevented?

NO

10

TARGET TO TREAT STRATEGY
Are the long term consequences of FM known?

NO, it is not a disease that will go away spontaneously

11

TARGET TO TREAT STRATEGY
Are there effective treatments for FM?

NO, they modestly benefit the patient

12

TARGET TO TREAT STRATEGY
Is there a target for disease outcome for FM?

Needs to be patient specific, there is no present treatment that is effective for the majority of patients

13

T/F Physical Therapy and Aerobic Exercise have shown to be just as effective as meds used for pain

TRUE

14

When should Tramadol/APAP be used in FMS?

for severe pain ONLY

15

What drugs should NOT be used in patients with FMS? (5)

BANSO
-Benzodiazepines
-Ambien
-NSAIDs
-Steroids (i.e. prednisone)
-Opioid Analgesics

16

Non-Pharm Therapy for FMS patients? (6)

-Patient education
-Support groups
-Cognitive-behavioral therapy
-Aerobic exercise -Strength training
-Dietary changes
-Physical therapy

17

What should patients with FMS avoid excessive intake of? (2)

-glutamate
-aspartate

(they will worsen symptoms--> recommend the Mediterranean food plan)

18

What are some dietary supplements that can be beneficial in patients with FMS? (3)

-omega 3 fatty acids
-vitamin C,D,E
-magnesium

19

Lyrica is considered a (3)

-analgesic
-anxiolytic
-anticonvulsant

20

Cymbalta precautions? (5)

-increase suicidal ideation
-increased BP
-hyponatremia (decreased Na)
-cause Serotonin Syndrome (in combo with tramadol or SSRI)
-do not abruptly stop

21

What are the 3 FDA approved meds for FMS?

-Lyrica
-Cymbalta
-Savella

22

Savella is more active on _____ , so it can be more helpful in decreasing drowsiness and fatigue, but may cause ......

NE; an increase in BP

23

T/F TCAs are FDA approved for FMS

FALSE; used off label

(should be taken at bedtime)

24

Common SE of TCAs? (4)

-Drowsiness
-Anticholinergic
-Increased appetite
-Metallic taste in mouth

25

T/F Lidocaine can be used as trigger point injection to reduce pain and tenderness

TRUE

(there are no systemic SE)