NSAIDs local anesthetics

Pharmacological intervention NSAIDs, local anesthetics, opioid analgesics, sodium-channel blockers Opioid analgesics, NSAIDs, calcium-channel blockers ... 

Ziconotide is a non-opioid, non-NSAID, non-local anesthetic used for the amelioration of chronic pain. In December 2004 the FDA approved ziconotide for intrathecal administration. The drug is derived from a marine snail toxin. Its mechanism of action has not yet been elucidated. Due to serious side effects or lack of efficacy when delivered through more conventional routes ziconotide must be administered in-trathecally. It s use is considered appropriate only for management of severe chronic pain in patients for whom intrathecal therapy is indicated. 

Superficial and deep heat Decreased muscle/joint pain and stiffness NSAIDs opioid analgesics local anesthetics - -... 

Analogous to the relationship between systemic opioids and NSAIDs, intraspinal narcotics often are combined with local anesthetics. This permits the nse of lower doses of both agents. 

Drugs implicated 3-Lactams other antibacterials NMBDs some NSAIDs quinolones mAbs proton pump inhib s P-Lactams quinine quinidine sulfonamides NSAIDs procainamide gold carbamazepine propylthiouracil ticlopidine P-Lactams ciprofloxacin sulfonamides lincomycin tetracycline NSAIDs carbamazepine allopurinol gold methyldopa mAbs NSAIDs p-lactams othCT antibiotics anti-convulsants antimalarials local anesthetics barbiturates quinolones dapsone... 

Opiates are indicated when adjunct medications (local anesthetics, acetaminophen, NSAIDS) are inadequate, but these medications should not be abandoned when opiates are added to the regimen drugs should be layered as pain management escalates. 

For routine post-operative analgesia, we rely on acetaminophen, local anesthetics, NSAIDS if not contraindicated, and, finally, opiates. Even if pain control is adequate without opiates, small doses of fentanyl may be used at the time of emergence to ease a patient through emergence delirium and the first moments in PACU when even parental presence is not a comfort... 

Capsaicin is used topically for symptomatic relief of pain. Unlike other pain medications that decrease inflammation (NSAIDs) or prevent transmission (local anesthetics) and perception of pain (narcotics), capsaicin works on a special type of nociceptors at the origin of the pain signal. Capsaicin activates the capsaicin or vaniloid 1 receptor, which is a special type of temperature-sensitive transient receptor potential (TRP) non-selective ion channel (TTRPl). Capsaicin also induces release of substance P, which is responsible for runny nose, watery eyes, sweating, and gastric juice production. Capsaicin also releases endorphins however, it appears that this does not play a major role in pain relief by capsaicin. 

Ischiogluteal bursitis is commonly found in patients who have a sedentary occupation. It was once called tailor s bottom, because tailors tended to sit all day on hard chair seats. The patient reports pain when they sit on a hard surface. The pain is usually unilateral. Point tenderness is present over the ischial tuberosity and will be relieved when the patient stands up. There will be no x-ray evidence found. An MRl or CAT scan may reveal a thickening of the bursa. The pain can be relieved by an injection of a local anesthetic into the area. The prescription of a non-steroidal anti-inflammatory medication (NSAID), the use of a cushion on the chair, as well as instructing the patienl to stand up for 1 minute every hour while working will relieve the condition. 

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