Article :Management of Chronic pain

  1. From Medscape:
    Adjunctive Agents in the Management of Chronic Pain
    David R. P. Guay, Pharm.D., FCP, FCCP, FASCP

    Chronic pain syndromes include cancer-related pain, postherpetic neuralgia, painful diabetic neuropathy, and central poststroke pain and are common in the elderly. Adjunctive (or adjuvant) analgesics, defined as drugs that do not contain acetaminophen and those not classified as nonsteroidal antiinflammatory or opioid agents, play a role in the management of chronic pain. The term "adjunctive" (or "adjuvant") is a misnomer as several of these agents may constitute first-line therapy for many chronic pain syndromes. Tricyclic antidepressants have formed the backbone of therapy for chronic neuropathic pain for years. However, the difficulty with using agents of this class, due to their clinically significant adverse-event potential, has led to the evaluation of other agents, most notably, the antiepileptic drugs. The most useful are gabapentin, carbamazepine, and lamotrigine. In selected patients, baclofen, mexiletine, and clonidine may be useful as well. Cancer-related pain may respond substantially to corticosteroids, and pain associated with bone metastases to parenteral bisphosphonates and strontium. Practitioners should consider these alternative agents when treating chronic pain. [Pharmacotherapy 21(9):1070-1081, 2001. 2001 Pharmacotherapy Publications, Inc.]

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    About NRSKarenRN, BSN, RN Moderator

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  3. by   hoolahan
    THank you Karen, this is great!!
  4. by   aimeee
    Excellent article indeed! Reinforces what I have been reading about various adjuvant drugs for chronic pain. I love to see the numbers from studies that back up what I've been learning.

    Thanks, Karen!