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Medicatie

  • J. L. Swaan
  • M. J. M. M. Giezeman
Chapter

Samenvatting

Dit hoofdstuk heeft tot doel om een overzicht te geven van veelgebruikte geneesmiddelen bij de behandeling van chronische pijn. De inhoud is in de eerste plaats gericht op artsen, maar is ook voor andere behandelaars zinvol, omdat zij te maken krijgen met patiënten die medicatie gebruiken. Invasieve pijnbehandeling blijft buiten beschouwing. In tegenstelling tot de behandeling van acute nociceptieve pijn is er weinig bewijs voor de effectiviteit van medicatie bij chronische pijn, met name op de lange termijn. We maken onderscheid in analgetica en co-analgetica. In de eerste categorie worden paracetamol, NSAID’s, tramadol en opioïden beschreven. Steeds meer onderzoeken tonen vooral de nadelen en gevaren aan van langdurig gebruik van opioïden bij niet-oncologische pijn. Bij de co-analgetica komen antidepressiva aan bod, zoals de tricyclische antidepressiva (TCA’s) en de selective serotonin reuptake inhibitors (SSRI’s) en serotonin and noradrenalin reuptake inhibitors (SNRI’s). Daarnaast behandelen we anti-epileptica (zoals de gabapentoïden) en bespreken we kort enkele andere middelen, zoals ketamine, capsaïcine en cannabis.

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Copyright information

© Bohn Stafleu van Loghum is een imprint van Springer Media B.V., onderdeel van Springer Nature 2019

Authors and Affiliations

  • J. L. Swaan
    • 1
  • M. J. M. M. Giezeman
    • 2
  1. 1.Rijndam RevalidatieRotterdamNederland
  2. 2.Isala kliniekenZwolleNederland

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