Term
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Definition
| Burning pain due to traumatic injury of a peripheral nerve |
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Term
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Definition
| Pain resulting from non-noxious stimulus (eg normal touch) |
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Term
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Definition
| Abnormally exaggerated subjective response to painful stimuli |
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Term
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Definition
| Abnormally painful response to a stimulus, especially a repeated stimulus... lowered pain threshold |
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Term
| When should observation for complications take place in Herpes zoster ? |
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Definition
| Affecting the forehead, need to refer to opthalmologist |
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Term
| What should be given for Herpes Zoster, and when should they be initiated |
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Definition
Acyclovir, famciclovir, or valacyclovir
Initiate within 3 days of onset of rash to be most effective |
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Term
| How should Herpes Zoster pain be treated? |
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Definition
Nerve blocks using amitriptylien and/or gabapentin
Treat with opioids if necessary |
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Term
First line for Trigeminal Neuralgia?
Second line? What are some difference between the two drugs? |
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Definition
1) Carbemazepine
2) Oxcarbazepine
Differences: Oxcarbazepine has fewer side effects and drug interactions, but a higher propensity to cause hyponatremia |
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Term
| If treating Trigeminal Neuralgia with carbemazepine is efficacious but side effects are troublesome, what are some options? |
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Definition
1) Switch to Oxcarbazepine (unless side effect was hyponatremia)
2) Reduce dose of carbemazepine and/or add baclofen
If that doesn't work
3) Add phenytoin or replace baclofen with phenytoin |
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Term
| S/E's of Carbemazepine/Oxcarbazepine |
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Definition
| Hyponatremia, Bone marrow suppression, ataxia, allergic reactions, hepatitis, drowziness, Dizziness |
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Term
| Acute Neuropathic Pains (2) |
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Definition
- Herpes Zoster
- Trigeminal Neuralgia |
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Term
| Chronic Neuropathic pains (3) |
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Definition
- Nerve root compression
- Complex Regional Pain Syndrome type I (CPRS I)
- Chronic peripheral Neuropathic pain |
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Term
| PT for Nerve root decompression |
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Definition
PT for Nerve root decompression
1) NSAIDS, APAP/codeine
2) Opioids if necessary |
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Term
| Some Causes of Chronic Periperhal Neuropathic Pain |
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Definition
| Postherpetic Neuralgia, diabetic neuropathy, causalgia, incisional neuralgias, phantom pain etc. |
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Term
Management of Chronic Peripheral Neuropathic Pain
First, second, third line? |
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Definition
1) TCAs or gabapentin or pregabalin
2) Lidocaine topical or SNRI (duloxetine or venlafaxine)
3) Opioids or tramadol
Other treatments include cannabis, methadone, lamotrigine, topiramate, valproic acid |
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Term
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Definition
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Term
| Carbemazepine in pregnancy? |
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Definition
associated with increased risk of major or minor malformations including tube defects.
If it is to be used, folic acid supplementation is recommended prior to conception and continued through pregnancy |
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Term
| What anti-epileptic agents should be avoided in pregnancy |
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Definition
| Gabapentin and pregabalin |
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Term
| How long should trial of a neuropathic pain med last? |
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Definition
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Term
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Definition
| Sometimes, eg. postherpetic neuralgia. After 1-3 months of pain relief gradually titrate off drug. |
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