Farmakoterapie neuropatické bolesti v dospělém věku

Title in English Pharmacotherapy for neuropathic pain in adults


Year of publication 2020
Type Article in Periodical
Magazine / Source Neurologie pro praxi
MU Faculty or unit

Faculty of Medicine

Keywords neuropathic pain; pharmacotherapy; guideline; antidepressive agents; anticonvulsants; opioids; side effects
Description Neuropathic pain is a severe clinical symptom of many different conditions affecting peripheral and central nervous system. Cancer-related and spondylogenic pain frequently has neuropathic component. Contrary to nociceptive pain, analgetics such as paracetamole or nonsteroid anti-inflammatory drugs are typically ineffective in neuropathic pain. All current foreign and Czech recommendations agree on the first-line treatment and partially on the other treatment lines. First line treatments include anticonvulsants, in particular alfa2 delta subunit of voltage gated calcium channels ligands (gabapentin, pregabalin), serotonine-norepinephrine reuptake inhibitors (duloxetine, venlafaxine) and tricyclic antidepressants (amitriptyline). Further therapy includes opioids (especially oxycodone), other anticonvulsants and topical agents (capsaicine, lidocain), eventually Botulinum toxine type A. In some cases combined therapy is necessary.
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