Pain Management

TOPICAL RX PHARMACY OFFERS YOUR PATIENTS AN ALTERNATIVE TO TRADITIONAL MEDICATION

Controlling Chronic Pain With Minimal Side Effects

Even when a patient’s underlying disease process is stable, uncontrolled pain can prevent your patient from leading a happy, productive and active life. Chronic pain may have countless causes and perpetuating factors which make it even more dif¬ficult to manage than acute pain. Although there are many commonly prescribed, commercially available pain relief medications to help chronic pain symptoms, they can also result in unwanted side effects such as drowsiness, dizziness or stomach irritation. Pharmacy compounding may alleviate many of your patient’s side effects by providing alternate dosage forms.

Smaller Medication Concentrations

Optimal pain management treatment may involve the use of medications that possess pain-relieving properties, including some antidepressants, anticonvulsants, antiarrhythmics, anesthetics, antiviral agents, and NMDA (N-methyl-D-aspartate), Antihypertensives, NMDA-receptor antagonists (such as dextromethorphan and ketamine) can block pain transmission in dorsal horn spinal neurons, reduce nociception, and decrease tolerance to and the need for opioid analgesics. [Anesth Analg 2001 Mar;92(3):739-44] By combining various agents which use different mechanisms to alter the sensation of pain, physicians have found that smaller concentrations of each medication can be used.

Our pharmacists can compound topical and transdermal creams and gels formulated to provide high local concentrations at the site of application (e.g., Nsaids for joint pain, neuroactive drugs for peripheral nerve effects), for trigger point application (e.g., Combinations of medications for neuropathic pain), or medications intended for systemic absorption. Side effects associated with oral administration can often be avoided when medications are used topically. Studies suggest that there are no great restrictions on the type of drug that can be incorporated into a properly compounded transdermal gel. By administering medications transdermally, they are not absorbed through the gastrointestinal system and do not undergo first-pass hepatic metabolism.

Pain Management

Pain management is essential because even when the underlying disease process is stable, uncontrolled pain prevents patients from working productively, enjoying recreation, or taking pleasure in their usual roles in the family and society. Chronic pain may have a myriad of causes and perpetuating factors, and therefore can be much more difficult to manage than acute pain, requiring a multidisciplinary approach and customized treatment protocols to meet the specific needs of each patient.

Optimal treatment may involve the use of medications that possess pain-relieving properties, including some antidepressants, anticonvulsants, antiarrhythmics, anesthetics, antiviral agents, and NMDA (N-methyl-D-aspartate) antagonists. NMDA-receptor antagonists, such as dextromethorphan and ketamine, can block pain transmission in dorsal horn spinal neurons, reduce nociception, and decrease tolerance to and the need for opioid analgesics. [Anesth Analg 2001 Mar;92(3):739-44] By combining various agents which utilize different mechanisms to alter the sensation of pain, physicians have found that smaller concentrations of each medication can be used.

Topical and transdermal creams and gels can be formulated to provide high local concentrations at the site of application (e.g., NSAIDs for joint pain), for trigger point application (e.g., combinations of medications for neuropathic pain), or in a base that will allow systemic absorption. Side effects associated with oral administration can often be avoided when medications are used topically. Studies suggest that there are no great restrictions on the type of drug that can be incorporated into a properly compounded transdermal gel. When medications are administered transdermally, they are not absorbed through the gastrointestinal system and do not undergo first-pass hepatic metabolism.

We work together with patient and practitioner to solve problems by customizing medications that meet the specific needs of each individual. Please contact our compounding pharmacist to discuss the dosage form, strength, and medication or combination that is most appropriate for your patient.