Category Archives: Drugs

Omega 3 – Anti-inflammatory Effects

Having a load of steroid response “Fibromyaglias” (as diagnosed by rheumatologists), I have been accumulating a list of anti-inflammatory agents. Omega 3 appears to have some promise.

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New Hope For Complex Regional Pain Syndrome I – 5 days Magnesium Infusions

Type I CRPS is a vague syndrome of inordinate pain with variable – vague neurologic weakness or numbness features (unlike type II in which the nerve has definely been cut). Typical scenario is after a wrist fracture in patients with … Continue reading

Posted in complex regional pain, Drugs, Injection | 3 Comments

Attenuation of Pain After Spinal Injury May be Possible

Microglia spinal support nerves become activated after nerve and spinal injury an greatly potential the pain. Animal experiments show minocycline, a tetracycline antibiotic known to inhibit microglia, can reduce post spinal pain in animal subjects.

Posted in Drugs, pain mechanisms | 1 Comment

Biphosphonates (bone building meds) and Jaw Necrosis – Not Seen in Oral Doses

Lon-term bone building meds intravenously (like Pamidronate) are associated with occasional oseonecrosis of jaw. Now there appears to be some hysteria that this can occur with oral medication. What are the facts?

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When to Use Opioids in Chronic Headaches

Afraid the “College” will get on your back for giving opioids to someone with chronic headaches? Can’t get your doctor to listen that you have no quality of life with your headaches? Well here are some guidelines (Not rules – … Continue reading

Posted in Drugs, Headaches | 1 Comment

Osteoarthritis Can Improve With Antibiotics – What Does That Mean -and would this prove safer than NSAID’s?

In osteoarthritics, Doxycycline, a tetracycline, was found to reduce knee joint space narrowing by 40% at 16 months and 33% at 30 months compared to placebo. In another study, after noticing a rapid reduction of inflammation in an OA case … Continue reading

Posted in arthritis, Drugs | 2 Comments

Steroid Joint Injection – Efficacy and Long Term Cartilage Effects

Are these legitimate arguments? 1) One shot should fix it and if it doesn’t then that’s it (I call this the “one shot wonder” attitude). I think the only person who could be sure to fix things at one go … Continue reading

Posted in Drugs, Hip Pains, Knee | 8 Comments

Optimal Fentanyl Patch Use

There is alot of confusion of what amounts to optimal fentanyl patch use. Many patients contend it only lasts 2 days. How does one adjust the dosage?

Posted in Drugs | 4 Comments

Acute Nerve Injury – Try Gabapentin and Tramadol

After a sciatic nerve as accidentally injected, gabapentin and tramadol helped the pain until some recovery came about.

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New Treatment for Chronic Daily Headaches – Mexiletine

Chronic daily headahces has to be the bane of most doctors frustrated by fact use of painkillers will potentially only make things worse. Now it looks like Mexiletine may help but …the patient has to be prepared to accept side … Continue reading

Posted in Drugs, Headaches | 6 Comments

Diabetic Peripheral Neuropathy – Pregabalin to 600mg or bust

I am used to 75-150 mg doses of pregabalin but doses of 300 mg BID are being used for diabetic peripheral neuropathy.

Posted in Drugs, neuropathic | 1 Comment

Tennis elbow and desperate – try Duloxetine

Two cases resistant to any treatment responded to Duloxetine suggesting complex origin.

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NSAID’s and Gastritis – new help

Arthritis pills longterm, particularly in the elderly, is a risky business. Stomach bleed have been reported to cause more deaths than car accidents and other injuries. These stats are now relatively old and comments from doctors has been that they … Continue reading

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Can’t Tolerate Arthritis Pills? – Try SAMe But Give It a Month.

Most NSAID’s (arthrtis pills) have a GI bleed (stomach bleed) rate of 10%. Diclofenac is 7%. Celebrex is 5% but only if they are not taking ASA. I have cases that cannot tolerate any NSAID’s or due to major GI … Continue reading

Posted in arthritis, Drugs | 1 Comment

Estrogenic Effects on Pain Blocked by ACE Inhibitors?

Quoted article starts by saying: “Many painful conditions occur more frequently in women, and estrogen is a predisposing factor. Estrogen may contribute to some pain syndromes by enhancing axon outgrowth by sensory dorsal root ganglion (DRG) neurons.” This effect may … Continue reading

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Etanercept (Enbrel) for Radiculitis (Sciatica)

The common and disabiling pain condition is chronic lumbar radiculopathy (chronic back pain/Sciatica). Despite the widespread promotion of treatments of neuropathic pain a recent analysis of neuropathic pain treatments has concluded the following: “To date, no medications have demonstrated efficacy … Continue reading

Posted in Back Pain, Drugs, Neck, neuropathic, radiculitis | 35 Comments

Simple Opioid Risk Tool

A talk by Dr. Pam Squire recommended a simple opioid risk tool called the ORT

Posted in Drugs | 2 Comments

Does Abrupt Estrogen Withdrawal trigger Pain?

Does sudden withdrawal of Estrogen cause a “aromatase inhibitor pain syndrome” leading to increased musculoskeletal pain? One author thinks so.

Posted in Drugs, Pathophysiology | 3 Comments

Glucosamine in RA -pain but not inflammation?

Glucosamine 1500 mg/day seemed to help the pain of RA but not signs of inflammation – add on for Acetaminophen in NSAID intolerant along with fluvastatin (Lescol)?

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Sodium Channel effects in Fentanyl vs Morphine

Sodiums channels are important in central and peripheral neuropathic pains. Morphine has no effect but Fentanyl (in Duragesic), Tramadol (in Tramacet), and Sufentanil (10 more potent fentanyl) do. This highlights there is a rationale for switching to a different opioid.

Posted in Drugs, Pathophysiology | 1 Comment

Opioids “Get No Respect”

Opioids for chronic pain: Taking stock – editorial Pain – in press Sept 2006 Discusses a study finding people on opioids were not better off. I feel they failed to comprehend that poor copers may be the ones that need … Continue reading

Posted in Drugs | 1 Comment