Medications Options

Anesthetics

          Bupivacaine  2-5%

          Lidocaine 2-10%

NMDA Ca channel antagonist

          Ketamine  5-10%

          Amantadine 5-20%

          Dextromethorpan 5-10%

          Orphenadrine 5-10%

          Haloperidol  0.5-2%

Glutamate antagonist

       Gabapentin 5-10%

AMPA (Na+ channel)

       Gabapentin 5-10%

          Carbamazepine  5%

          Phenytoin  2-10%   

          Valporic Acid 2-5%

a2-Agonist

       Clonidine 0.1-0.3%

NE reuptake inhibitors

          Tricyclic antidepressants

a1-Antagonist

       Prazosin

          Phentolamine

GABA b Agonist

          Baclofen

NON-NMDA Ca2 + Channel blocker

       Nifedipine

Opioids     

       Morphine 1-5%

          Hydrocodone 0.25-1%

          Fentanyl 100mcg/0.1 ml

 

 

 

 

 
 
Sample of Transdermal Pain Medication Prescription Application

 

Rx  Ketoprofen 20%__30%__40%__ 50%*__

Or Other NSAID in strength of choice or in different combinations

Diclofenac 1-10%

Ibuprofen 10-40%

Indomethocin  10-20%

Piroxicam 0.5-2%

 

Rx  Guaifenesin 10 - 40%

Alone or in combination with NSAID for muscle sprains,

plantar fasiitis, and nocturnal leg cramps.

 

Normal Base used VPC (Vanishing Penetrating Cream) (onset 15-30 minutes)

Base Options

Base              Advantages        Disadvantage

 

Anhydrous PGE        For trigger point         Low strengths

 

Lipoderm                 High Strength             Expensive

                                Non-Sticky

 

PLO                          Effective                   Sticky                                                                 Under Dentures

 

VPC                          High Strengths         

                               Non-Sticky

                                Cost effective

 

Speed Gel                 Liquid (for ears)          Runny 

 

Spray                       Sensitive Skin        Can Run

 
 

A New Approach

Considering the barriers to effective pain management shared by patients and providers, it is time to consider a new approach for the twenty first century.  Using low-dose concomitant agents with complementary modes of action can minimize the problem of side effects.  Also knowledge of receptor locations to avoid oral or infusion systemic doses when it become necessary to decrease the risk of side effects.
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


  Ó Partners in Care – http://www.picrx.com