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Pharmacotherapy of Chronic Pain

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Neurosurgical Management of Pain
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Abstract

The pharmacotherapy of chronic pain is complex because it requires knowledge of psychopharmacology, vasoactive drugs, nonsteroidal anti-inflammatory drugs, narcotics, antidepressants, tranquilizing agents, and hypnotics. There is no single set formula that is applicable to all chronic pain states, because the origins of chronic pain are multiple, and as varied as the individuals who have the problem. Therefore, in order to use a variety of medications, one must understand the mechanism of action of each drug so that it can be applied for a specific situation. Additionally, drug interaction, synergy, antagonism, and side effects are important considerations in pharmacotherapy.

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References

  1. Hendler N. The Diagnosis and Nonsurgical Management of Chronic Pain. New York: Raven Press; 1981.

    Google Scholar 

  2. Bennet JP, Logan WJ, Snyder SH. Amino acid as central nervous system transmitters: the influence of ions, amino acid analogues, and ontogeny on transport systems for L-glutamate and D-depatic acids and glycine into the central nervous synaptosomes of the rat. J Neurochem. 1973;21:1533–1550.

    Article  Google Scholar 

  3. Birnbaumer L. G proteins in signal transduction: Ann Rev Pharmacol Toxicol. 1990;30:675–705.

    Article  CAS  Google Scholar 

  4. Colclough G. et al. Mexiletine for chronic pain (letter). Lancet. 1993;342:1484–1485.

    Article  PubMed  CAS  Google Scholar 

  5. Depoortere H, Zivkovic B, Lloyd KG, et al. Zolpidem, a novel nonbenzodiazepine hypnotic: neuropharmacological and behavioral effects. J Pharmacol Exp Ther. 1986;237:649–658.

    PubMed  CAS  Google Scholar 

  6. DeVaul R, Hall R, Faillace L. Drug use by the polysurgical patient. Am J Psychiatr. 1978; 135:682–685.

    PubMed  CAS  Google Scholar 

  7. Hall R, Hall AK, Gardner ER, et al. Effectiveness of tricyclic antidepressants in the management of chronic pain. Paper presented at the annual meeting of the Academy of Psychosomatic Medicine, San Francisco, Calif, October 1979.

    Google Scholar 

  8. Taub A. The use of psychotropic drugs alone and adjunctively in the treatment of otherwise intractable pain: post-therapeutic neuralgia: disseminated visceral neoplasm. In: Voris NC, Whisler WW, eds. Pain. Springfield, Ill: Charles C. Thomas; 1975.

    Google Scholar 

  9. Jakubovic A. Psychoactive agents and enkephalin degradation. In: Nandkumar S, Alexander D, eds. Endorphins and Opiate Antagonists in Psychiatric Research: Clinical Implications. New York: Plenum; 1982:89–97.

    Chapter  Google Scholar 

  10. Pasternak G. Psychotropic drugs and chronic pain. In: Hendler N, Long D, Wise T, eds. Diagnosis and Treatment of Chronic Pain. Littletown, Mass: Wright-PSG; 1982:201–210.

    Google Scholar 

  11. Portenoy RK, Farkash. A practical management of non-malignant pain in the elderly. Geriatrics. 1988;43:29–47.

    PubMed  CAS  Google Scholar 

  12. Twycross RG, Fairfield S. Pain in far advanced center. Pain. 1982;14:303–310.

    Article  PubMed  CAS  Google Scholar 

  13. Hokfelt T, Jonsson G, Linbrink P. Electron microscope identification of monoamine nerve ending particles in rat brain homogenates. Brain Res. 1970;22:147–151.

    Article  PubMed  CAS  Google Scholar 

  14. Pert C, Snyder S. Opiate receptor: demonstration in nervous tissue. Science. 1973;179:1011–1014.

    Article  PubMed  CAS  Google Scholar 

  15. Synder S. The opiate receptor and morphine-like peptides in the brain. Am J Psychiatr. 1978;135:645–652.

    Google Scholar 

  16. Hosobuchi Y, Adams J, Linchitz R. Pain relief by electrical stimulation of the central gray matter in humans and its reversal by naloxone. Science. 1977;197:183–186.

    Article  PubMed  CAS  Google Scholar 

  17. Sewell RDE, Spencer PSJ. Modification of the antinociceptive activity of narcotic agonists and antagonists by intraventricular injection of biogenic amines in mice. Br J Pharmacol. 1974; 51:140–141.

    Google Scholar 

  18. Klipper A, Kolodny AL. Nonsteroidal anti-inflammatory drugs. In: Hendler N, Long D, Wise T, eds. Diagnosis and Treatment of Chronic Pain. Littletown, Mass: Wright-PSG; 1982:183–192.

    Google Scholar 

  19. Lanza FL. Gastrointestinal toxicity of newer NSAIDs. Am J Gastroenterol. 1993;88:1318–1323.

    PubMed  CAS  Google Scholar 

  20. Walt RD. Misoprotol for the treatment of peptic ulcer and anti-inflammatory drug induced gastroduodenal ulceration. N Engl J Med. 1992;327:1575–1580.

    Article  PubMed  CAS  Google Scholar 

  21. Richelson G. Side effects of old and new generation antidepressants: a pharmacological framework. J Clin Psychiatr Monogr. 1991;9:13–19.

    Google Scholar 

  22. Montillia E, Frederick WS, Cass LJ. Analgesic effects of methotrimeprazine and morphine: a clinical comparison. Arch Intern Med. 1963;111:275–278.

    Google Scholar 

  23. Hendler N, Cimini C, Ma T, Long D. The comparison between cognitive impairment due to benzodiazepines and narcotics. Am J Psychiatr. 1980; 137:828–830.

    PubMed  CAS  Google Scholar 

  24. Hendler N. Benzodiazepines: mechanism of action and appropriate use. In: Day S, ed. Life Stress—A Companion to the Life Sciences. New York: Van Nostrand Reinhold; 1982;III.

    Google Scholar 

  25. Zivkovic B, Perrault G, Morel E, et al. Comparative pharmacology of zolpidem and other hypnotics and sleep inducers in imidazopyridines in sleep disorders. Sauvanet JP, Kanger SZ, Morselli PL, eds. New York: Raven Press; 1988:97–110.

    Google Scholar 

  26. Walsh JK, Schweitzer PK, Sugerman JL, et al. Transient insomnia associated with a three hour phase advance of sleep time and treatment with zolpidem. Clin Psychopharmacol. 1990;10:184–189.

    Article  CAS  Google Scholar 

  27. Oswald I, Adam K. A new look at short acting hypnotics. In: Imidagopyridines in Sleep Disorder. Ed. by Sauvanet JP, Kanger SZ, Morselli PL. New York: Raven Press; 1988:253–259.

    Google Scholar 

  28. Scharf MB, Mayleben OW, Kaffeman M, et al. Dose response effects of zolpidem in normal geriatric subject. J Clin Psychiatr. 1991;52:77–83.

    CAS  Google Scholar 

  29. Kanner R, Foley K. Patterns of narcotic drug use in a cancer pain clinic. In: Millman R, Crohman P Jr, Lowinson J. Ann NY Acad Sci. 1981;362:161–172.

    Google Scholar 

  30. Twycross R. Narcotic analgesics in clinical practice. In: Bonica J, Lindblom L, Iggo A. Advances in Pain Research and Therapy. New York: Raven Press; 1983;5:435–459.

    Google Scholar 

  31. Baiter K. Tutorial 8: a review of pain anatomy and physiology. Pain Digest. 1992;II:306–330.

    Google Scholar 

  32. Melzack R. A tragedy of needless pain. Sci Am. 1990;262:27–33.

    Article  PubMed  CAS  Google Scholar 

  33. Portenoy RK. Chronic opiate therapy and non-malignant pain. J Pain Symp Manage. 1990;5 (suppl):46–62.

    Article  Google Scholar 

  34. Goldstein FJ, Mojaverian P, Ossipov MH, Swanson BN. Elevation in analgesic effect and plasma levels of morphine by desipramine in rats. Pain. 1982; 14:279–282.

    Article  PubMed  CAS  Google Scholar 

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© 1997 Springer Science+Business Media New York

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Hendler, N. (1997). Pharmacotherapy of Chronic Pain. In: North, R.B., Levy, R.M. (eds) Neurosurgical Management of Pain. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1938-5_11

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  • DOI: https://doi.org/10.1007/978-1-4612-1938-5_11

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7348-6

  • Online ISBN: 978-1-4612-1938-5

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