Advertisement

Pharmacotherapy of Chronic Pain

  • Nelson Hendler

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.

Keywords

Chronic Pain Biogenic Amine Cancer Pain Pain Perception Diabetic Peripheral Neuropathy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Hendler N. The Diagnosis and Nonsurgical Management of Chronic Pain. New York: Raven Press; 1981.Google Scholar
  2. 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.CrossRefGoogle Scholar
  3. 3.
    Birnbaumer L. G proteins in signal transduction: Ann Rev Pharmacol Toxicol. 1990;30:675–705.CrossRefGoogle Scholar
  4. 4.
    Colclough G. et al. Mexiletine for chronic pain (letter). Lancet. 1993;342:1484–1485.PubMedCrossRefGoogle Scholar
  5. 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.PubMedGoogle Scholar
  6. 6.
    DeVaul R, Hall R, Faillace L. Drug use by the polysurgical patient. Am J Psychiatr. 1978; 135:682–685.PubMedGoogle Scholar
  7. 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. 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. 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.CrossRefGoogle Scholar
  10. 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. 11.
    Portenoy RK, Farkash. A practical management of non-malignant pain in the elderly. Geriatrics. 1988;43:29–47.PubMedGoogle Scholar
  12. 12.
    Twycross RG, Fairfield S. Pain in far advanced center. Pain. 1982;14:303–310.PubMedCrossRefGoogle Scholar
  13. 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.PubMedCrossRefGoogle Scholar
  14. 14.
    Pert C, Snyder S. Opiate receptor: demonstration in nervous tissue. Science. 1973;179:1011–1014.PubMedCrossRefGoogle Scholar
  15. 15.
    Synder S. The opiate receptor and morphine-like peptides in the brain. Am J Psychiatr. 1978;135:645–652.Google Scholar
  16. 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.PubMedCrossRefGoogle Scholar
  17. 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. 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. 19.
    Lanza FL. Gastrointestinal toxicity of newer NSAIDs. Am J Gastroenterol. 1993;88:1318–1323.PubMedGoogle Scholar
  20. 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.PubMedCrossRefGoogle Scholar
  21. 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. 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. 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.PubMedGoogle Scholar
  24. 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. 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. 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.CrossRefGoogle Scholar
  27. 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. 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.Google Scholar
  29. 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. 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. 31.
    Baiter K. Tutorial 8: a review of pain anatomy and physiology. Pain Digest. 1992;II:306–330.Google Scholar
  32. 32.
    Melzack R. A tragedy of needless pain. Sci Am. 1990;262:27–33.PubMedCrossRefGoogle Scholar
  33. 33.
    Portenoy RK. Chronic opiate therapy and non-malignant pain. J Pain Symp Manage. 1990;5 (suppl):46–62.CrossRefGoogle Scholar
  34. 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.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Nelson Hendler

There are no affiliations available

Personalised recommendations