tailieunhanh - Chapter 012. Pain: Pathophysiology and Management (Part 6)

Antidepressants, anticonvulsants, and antiarrhythmics have not been approved by the . Food and Drug Administration (FDA) for the treatment of in doses up to 1800 mg/d is FDA approved for postherpetic : 5-HT, serotonin; NE, they are effective for these common types of pain and are available without prescription, COX inhibitors are by far the most commonly used analgesics. They are absorbed well from the gastrointestinal tract and, with occasional use, have only minimal side effects. With chronic use, gastric irritation is a common side effect of aspirin and NSAIDs and is the problem that most frequently limits. | Chapter 012. Pain Pathophysiology and Management Part 6 Antidepressants anticonvulsants and antiarrhythmics have not been approved by the . Food and Drug Administration FDA for the treatment of pain Gabapentin in doses up to 1800 mg d is FDA approved for postherpetic 5-HT serotonin NE they are effective for these common types of pain and are available without prescription COX inhibitors are by far the most commonly used analgesics. They are absorbed well from the gastrointestinal tract and with occasional use have only minimal side effects. With chronic use gastric irritation is a common side effect of aspirin and NSAIDs and is the problem that most frequently limits the dose that can be given. Gastric irritation is most severe with aspirin which may cause erosion and ulceration of the gastric mucosa leading to bleeding or perforation. Because aspirin irreversibly acetylates platelets and thereby interferes with coagulation of the blood gastrointestinal bleeding is a particular risk. Increased age and history of gastrointestinal disease increase the risks of aspirin and NSAIDs. In addition to NSAIDs well-known gastrointestinal toxicity nephrotoxicity is a significant problem for patients using them on a chronic basis and patients at risk for renal insufficiency should be monitored closely. NSAIDs also cause an increase in blood pressure in a significant number of individuals. Long-term treatment with NSAIDs requires regular blood pressure monitoring and treatment if necessary. Although toxic to the liver when taken in a high dose acetaminophen rarely produces gastric irritation and does not interfere with platelet introduction of a parenteral form of NSAID ketorolac extends the usefulness of this class of compounds in the management of acute severe pain. Ketorolac is sufficiently potent and rapid in onset to supplant opioids for many patients with acute severe headache and musculoskeletal are two major