Pharmacologic Management of Pain

Pfefferbaum, B. and Hagberg, C.A. (1993) Pharmacological management of pain in children. / Am Acad Child Adolesc Psychiatry 32 235-242. 

Shannon, M. and Berde, C.B. (1989) Pharmacologic management of pain in children and adolescents. Pediatr Clin North Am 36 855-871. 

Pharmacologic management of pain involves administering pain medication to relieve the patient s pain. These include non-narcotic analgesics, nonsterioidal anti-inflammatory dmgs (NSAIDs), narcotic analgesics, and salicylates. 

Drug treatment is one of the most important principles in the management of pain. The WHO has described in its pain relief ladder a practical approach to the choice of analgesics in symptomatic treatment of cancer pain. The ladder is based on a pharmacological approach rather than based on the physiology of pain. 

Pharo GH, Zhou L. Pharmacologic management of cancer pain. J Am Osteopath Assoc. 2005 105(suppl 5) S21-S28. 

Effective management of pain and other symptoms associated with life-threatening disease is usually attainable with the proper combination of pharmacological and nonpharmacological interventions. Pharmacists can, and should, play an important role in ensuring that their patients receive this care when it is needed. 

Shimp, L.A. Safety issues in the pharmacologic management of chronic pain in the elderly. Pharmacotherapy 1998, 18 (6), 1313-1322. 

McCleane, G. The pharmacological management of neuropathic pain A review. Anaesthesia On-Line 2000. 

Celecoxib is currently indicated for the relief of signs and symptoms of osteoarthritis and rheumatoid arthritis and to reduce the number of adenomatous colorectal polyps in familial adenomatous polyposis as an adjunct to usual care. Celecoxib is at least as effective as naproxen in the symptomatic management of osteoarthritis and at least as effective as naproxen and diclofenac in the symptomatic treatment of rheumatoid arthritis, and it is less likely to cause adverse Gl effects. Celecoxib appears to be effective in the management of pain associated with both of these arthritic conditions, but effectiveness in acute or chronic pain has not been fully demonstrated. Unlike aspirin, celecoxib does not exhibit antiplatelet activity. Concomitant administration of aspirin and celecoxib may increase the incidence of Gl side effects. Another notable potential drug interaction with celecoxib is its ability, like other NSAIDs, to reduce the blood pressure response to angiotensin-converting enzyme inhibitors. A more detailed discussion of the chemical, pharmacological, pharmacokinetic, and clinical aspects of celecoxib is available (81). 

Dworkin RH, O Connor AB, Backonja M, et al. Pharmacologic management of neuropathic pain evidence-based recommendations. Pain 2007 132 237-251. 

Moulin DE, Clark AJ, Gilron I, et aL Pharmacological management of chronic neuropathic pain - consensus statement and guidelines from the Canadian Pain Society. Pain Res Manag 2007 12 13-21. 

Gordon DB, Love G. Pharmacologic management of neuropathic pain. Pain ManagNurs 2004 5(4 Suppl. 1) 19-33. 

Ferrell B, Argoff CE, Epplin J, Fine P, Gloth FM, Herr K, Katz JD, Mehr DR, Reid C, Reisner L. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc 2009 57(8) 1331-1346. 

Kraemer FW, Rose JB. Pharmacologic management of acute pediatric pain. Anesthesiology Clin 2009 27 241-268. 

Blake AD, Bot G, Reisine T. Molecular pharmacology of the opioid receptors. In Molecular Neurobiology of Pain. Progress in Pain Research and Management, Vol. 9 (Borsook D, ed), International Association for the Study of Pain Press, USA, 1997 259-273. 

Rheumatoid arthritis and osteoarthritis represent the two primary pathologic conditions that affect the joints and periarticular structures. Although the causes underlying these conditions are quite different from one another, both conditions can cause severe pain and deformity in various joints in the body. Likewise, pharmacologic management plays an important role in the treatment of each disorder. Because physical therapists and other rehabilitation specialists often work with patients who have rheumatoid arthritis or osteoarthritis, an understanding of the types of drugs used to treat these diseases is important. 

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