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Chelsea Angelica V.

Acejo BSN III-A Treatment of Neuropathic Pain Summary:

March 3, 2011

Neuropathic pain results from an injury or diseases that affect the nerves in both central and peripheral nervous system. Some forms of pain are because of sensitization of neurons in the central pathways. Included also with pain are some symptoms such as numbness, dysaesthesia and formication in anatomically recognized patterns. Treatment for neuropathic pain includes antidepressants of the tricyclic type with a dose of 10 and 12.5 mg at bedtime and then increased slowly. Anti-epileptic drugs are also used in treating neuropathic pain but until recently there was almost no trial evidence for efficacy. Usually the side effects manifested when using anti-epileptic drugs are drowsiness, dizziness and ataxia. Though for some years Gabapentin is an epileptic drug used for neuropathic pain. Opioids are also another kind of drug used for neuropathic pain treatment. It is used in a time-contingent manner and usually given in high doses. An example of an Opioid is Tramadol which was trialled successfully in patients with this kind of pain. If pain was not relieved by these drugs usually surgery would be indicated for the patients and other modalities deferred to pain physicians and anaesthetists or other specialists experienced in their use. Learnings: After reading the article, Ive learned that Neuropathic pain is a problem that develops after injury to any level of the nervous system, peripheral or central. The sympathetic nervous system may be involved, causing sympathetically maintained pain. Specific syndromes include Neuralgia. Several classes of drugs are moderately effective but complete or near-complete relief is unlikely. Antidepressants and anticonvulsants are most commonly used. Evidence of efficacy is strong for several antidepressants and anticonvulsants. Opioid analgesics can provide some relief but are less effective than for Nociceptive pain; adverse effects may prevent adequate analgesia. According from the article, treatment of this would be indeed very challenging but for a few years management will be broadened to include novel treatments that are under trial in laboratory settings. Application: This article can be applied with our topic in NCM 104, since it talks about Neurologic disorders. This gave us a brief and clear introduction about Neuropathic pain as well. We could apply this when our patients would have this kind of problem in which we can give proper health teachings about the treatments / medications given to them by the physician.