Tag Archives: Lidocaine

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 »

Treatment of the epilepsy patient with cardiac disease

Atrial fibrillation (AF) occurs in 9% of patients over the age of 80 years, and prevalence is increasing as the population ages. All patients with AF should be anti-coagulated with warfarin for stroke prevention unless there is a clear contraindication. It is therefore particularly important in this patient group that seizures are well controlled, as… Read More »

Delirium: Etiology

Delirium has a wide variety of etiologies, which may occur alone or in combination (). These include primary cerebral disorders, systemic disturbances that affect cerebral function, drug and toxin exposure (including intoxication and withdrawal), and a range of factors that can contribute to delirium but have an uncertain role as etiological factors by themselves (psychological… Read More »

Which drug has shown benefit in treating SUNCT?

Which medication has shown benefit in treating SUNCT and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA)? A. Lamotrigine (Lamictal) B. Gabapentin (Neurontin) C. Topiramate (Topamax) D. Lidocaine E. All of the above The answer is E. SUNCT and SUNA are primary headache syndromes, classified as TACs, and associated with hypothalamic activation. They… Read More »

Which drug used for the prevention of migraine has been associated with PCOS?

Which medication used for the prevention of migraine headaches has been associated with polycystic ovarian syndrome (PCOS)? A. Divalproex sodium (Depakote) B. Topiramate (Topamax) C. Lamotrigine (Lamictal) D. Magnesium E. Propranolol (Inderal) The answer is A. Polycystic ovarian syndrome (PCOS) is characterized by clinical signs of endocrine dysfunction, such as irregular menstruation, hirsutism, and infertility,… Read More »

Which of the drugs effective in treating patients with SUNCT?

Which of the following has been shown to be effective in treating patients with SUNCT? A. Intranasal zolmitriptan (Zomig) B. Inhalational oxygen C. Intramuscular Indomethacin (Indocin) D. Intravenous (IV) lidocaine E. Oral Ketoralac (Toradol) The answer is D. As distinct from PH and hemicrania continua, SUNCT/ SUNA does not respond to indomethacin (Indocin). Although CHs… Read More »

Most effective in preventing attacks of short-lasting unilateral neuralgiform headache attacks…

Which of the following oral agents has been shown to be most effective in preventing attacks of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)? A. Gabapentin (Neurontin) B. Indomethacin (Indocin) C. Carbamazepine (Tegretol) D. Lamotrigine (Lamictal) E. Pregabalin (Lyrica) The answer is D. SUNCT/SUNA is particularly refractory to prevention with oral… Read More »

Which of the treatments is the best short-term prevention for CHs?

Which of the following available treatments is the best short-term prevention for CHs? A. Steroids B. Injectable sumatriptan (Imitrex) C. Oxygen inhalation D. Intranasal lidocaine E. Methysergide (Sansert) The answer is A. Oral steroids are the most effective short-term preventa-tive therapy for CH. They may be used while the doses of long-term preventative medications, such… Read More »

Headaches

Several types of headaches are unique to sleep and its disorders. Thus, evaluation of headache should also include temporal information during the 24-hour cycle, which may offer clues to the diagnosis. Key headaches that are classically associated with sleep include cluster headaches, migraines, chronic paroxysmal hemicrania, and hypnic headaches. Additionally, sleep apnea can help trigger… Read More »