FINAL-Chronic Pain Flashcards
(44 cards)
Chronic Pain definition…
Persistent pain recurring for greater than 3 months or 1 month after resolution of an acute tissue injury or non-healing lesion
Acute vs Chronic Pain tx goals…
Acute-CESSATION of pain
Chronic-Decrease pain and increase QOL
Cycle of Pain
Pain-Avoidance Behavior-Decreased Mobility-Altered functional status-Diminished self-efficacy-Social Limitations-Pain Augmented
Meds to use for Neuropathic Pain
Gabapentin (Neurontin) G. enacarbil (Horizant) Pregabalin (Lyrica) Gralise Carbamazepine (Tegretol) Topiramate Lamotrigine
Use for Horizant
Gabapentin Enacarbil
- PHN
- RLS
Use for Pregabalin
Lyrica
- Good for SEDATION
- Peripheral Edema
Use for Gralise
PHN
DOC for Carbamazepine
Trigeminal Neuralgia
Carbamazepine Brand
Tegretol
Membrane Stabilizing Anticonvulsants
Topiramate
Lamotrigine
Antidepressants preferred for pain
TCAs Amitriptyline (Elavil) Nortriptyline (Pamelor) Desipramine (Norpramin) Imipramine (Tofranil)
Amitriptyline
Elavil
Nortriptiyline
Pamelor
Desipramine
Norpramine
Imipramine
Tofranil
Side Effects of TCAs
Dry mouth Somnolence Sedation Constipation Cardiac
SNRIs important to chronic pain tx…
Duloxetine (Cymbalta)
Venlafaxine(Effexor)
Milnacipran (Savella)
Duloxetine indication for
CYMBALTA
FDA INDICATED FOR
- Fibromyalgia
- Low Back Pain
- Diabetic Neuropathy
Milnacipran Indication
SAVELLA
FDA approved for FIBROMYALGIA
SSRIs are not proven effective for pain tx, but are used in pts with
Depression
Benzos
Shown in one study to provide some efficacy for neuralgic pain
NMDA Receptor Agonists
Dextromethorphan
Memantine
Methadone
Amantidine
NMDA receptor agonists should be used….
Neuropathic pain
PHN, Diabetic neuropathy, Phantom limb pain, Peripheral nerve injury, CRPS etc
NSAIDs should be used for….
Patients with back pain