Analgesics adjuvant

TABLE 30-5. Selected Adjuvant Analgesics and Suggested Dosing54-58... 

McDonald AA, Portenoy RK. How to use antidepressants and anticonvulsants as adjuvant analgesics in the treatment of neuropathic cancer pain. J Support Oncol 2006 4(l) 43-52. 

Backonja, M.-M. Local anesthetics as adjuvant analgesics, J. Pain Symptom. Manage. 1994, 9, 491-499. 

Sloan, P., Basta, M., Storey, P., Gunten, von, C. Mexilitine as an adjuvant analgesic for the management of neuropathic pain, Anesth. Analg. 1999, 89, 760-761. 

Reddy S, Patt RB. The benzodiazepines as adjuvant analgesics. J Pain Symptom Manage 1994 9(8) 510-4. 

Sloan P, Basta M, Storey P, von Gunten C. Mexiletine as an adjuvant analgesic for the management of neuropathic cancer pain. Anesth Analg 1999 89(3) 760-1. 

Breitbart, W. Psychotropic adjuvant analgesics for pain in cancer and AIDS. Psychooncology 1998, 7, 33-45. 

Portenoy, R.K. Adjuvant analgesic agents. Hematol. Oncol. Clin. North Am. 1996, 0 (1), 103-119. 

Semenchuk M. Adjuvant analgesics for management of neuropathic pain. In Beizer JL, ed. Chnical Pharmacy Newswatch, Vol. 6. Parke-Davis, 1999 1. 

Takahashi H, Shimoyama N. A prospective open-label trial of gabapentin as an adjuvant analgesic with opioids for Japanese patients with neuropathic cancer pain. Int J Clin Oncol 2010 15(1) 46-51. 

It is mandatory to set up a realistic goal prior to initiating pain management. Duloxetine, as an adjuvant analgesic, may contribute to pain relief gradually but not instantaneously. Previous studies have demonstrated mild to moderate pain relief in patients who responded to duloxetine treatment. The efficacy and timeline with duloxetine were quite different than analgesics such as opioids or NSAIDs that were not FDA approved for DPN and/or fibromyalgia. 

In addition to these anti-inflammatory and immunosuppressive activities of pain control, oral corticosteroids have several other properties that make them useful as multipurpose adjuvant analgesics, especially in patients with pain associated with chronic disease or cancer. The mechanisms of these effects are less well worked out but corticosteroids also stimulate the erythroid cells of bone marrow and prolong the survival time of erythrocytes and platelets. They promote gluconeogenesis and protein catabolism. They reduce chemotherapy-induced nausea and vomiting, and alleviate dyspnea, effusion... 

Knotkova H, Pappagallo M. Adjuvant analgesics. Anesthesiol Clin North Am 2007 27 775-786. 

Lussier D, Huskey A, Portenoy R. Adjuvant analgesics in cancer pain management. Oncologist 2004 9 571-591. 

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