Tag Archives: Ketamine

Overview of New Anxiolytics

Although the benzodiazepines have been the treatment of choice for anxiety disorders for many years, unfavorable aspects to their side-effect profile have initiated efforts to develop new-generation antianxiety agents. Over the past decade, scientists have been searching for compounds that retain the robust anxiolytic efficacy of benzodiazepines, but lack a number of unwanted properties, including… Read More »

Pharmacological Treatment of Pain

While medications are often prescribed for all types of chronic pain, research has consistently shown that several classes have proven efficacy for the treatment of neuropathic pain. Ideally, pharmacotherapy of pain would be specifically selected on the basis of considerations of etiology (e.g., ischemic, neuropathic), pathophysiology (e.g., demyelination, central pain), and anatomy (e.g., C fibers,… Read More »

Selected Chronic Pain Conditions

Postherpetic Neuralgia Postherpetic neuralgia is defined as pain persisting or recurring at the site of shingles at least 3 months after the onset of the acute varicella zoster viral rash. Postherpetic neuralgia occurs in about 10% of patients with acute herpes zoster. More than half of patients over 65 years of age with shingles develop… Read More »

Post-Amputation Pain

Pain following limb amputation can be of many causes and is said to be an amalgam of post-operative pain, stump pain of nociceptive or neuropathic cause, phantom pain, and other pains related to disability. Careful consideration should be given to cause so treatment can be properly directed. An amputee is said to be ‘established’ one… Read More »

Neuropathic Pain — an Overview

Clinical description The traditional neuroanatomical model of the sensory system for pain fails to explain a variety of pain syndromes that are associated with damage to the sensory nerve, or the pathways through dorsal horn to cortex. Likewise, the gate control model of pain, useful as it is for explaining the modulating effect of large… Read More »

Management of Anxiety

Physician-Patient Relationship The physician must establish a working therapeutic alliance with any patient (). In the crisis of cancer, heart disease, or surgery, the physician is viewed as the individual who can literally save one’s life and has a unique task. This demands supportive and empathic care in both imparting information and offering hope regardless… Read More »

Opioids In Chronic Pain

The use of opioids in pain of non-malignant origin is controversial and depends on a proper understanding of the nature of chronic pain, and the strategy of its management. Patients with chronic pain who take opioids must understand the rationale for the use and be prepared to be an active partner in the management of… Read More »

Intrathecal drug delivery systems

There is increasing use of such systems. Indications These may be divided into two and it is convenient to consider them separately. 1. Baclofen for the management of spasticity. The indication is provoked by pain from the continuing muscle spasm; additional benefits are improvement in function and for disabled bed-bound patients ease of nursing care.… Read More »

Ketamine And Other NMDA Antagonists

Ketamine is an anaesthetic drug with a few notable features which have resulted in its introduction to pain clinic practice. The rationale for its use is supported by animal studies which allow tentative conclusions to be drawn about a mechanism of action. However, the extrapolation of animal data, based on electrophysiological and behavioural studies, to… Read More »

Which of the short-acting triptans has been shown to prevent menstrual migraine?

Which of the following short-acting triptans has been shown to prevent menstrual migraine in a large, randomized, placebo-controlled trial? A. Zolmitriptan (Zomig) B. Eletriptan (Relpax) C. Sumatriptan (Imitrex) D. Rizatriptan (Maxalt) E. None of the above The answer is A. Currently, no triptan is FDA approved for the short-term, peri-menstrual prevention of menstrual migraine. However,… Read More »