Pharmacotherapeutic Management of Neuropathic Pain in End-Stage Renal Disease

被引:10
作者
Raouf, Mena [1 ]
Bettinger, Jeffrey [2 ]
Wegrzyn, Erica W. [3 ]
Mathew, Roy O. [4 ]
Fudin, Jeffrey J. [3 ]
机构
[1] Kaiser Permanente, Dept Pain Management, 301 S 320th St, Federal Way, WA 98003 USA
[2] Saratoga Hosp Med Grp, Dept Pain Management, Saratoga Springs, NY USA
[3] Stratton VA Med Ctr, Dept Pain Management, Albany, NY USA
[4] William Jennings Bryan Dorn VA Med Ctr, Dept Nephrol, Columbia, SC USA
关键词
Neuropathic pain; Neuropathy; Opioids; Pain; CHRONIC KIDNEY-DISEASE; NEUROLOGICAL COMPLICATIONS; DRUG-METABOLISM; PHARMACOKINETICS; SAFETY; IMPAIRMENT; PREGABALIN; EFFICACY; ANTIDEPRESSANTS; HEMODIALYSIS;
D O I
10.1159/000504299
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Chronic noncancer pain is pervasive throughout the general patient population, transcending all chronic disease states. Patients with end-stage renal disease (ESRD) present a complicated population for which medication management requires careful consideration of the pathogenesis of ESRD and intimate knowledge of pharmacology. The origin of pain must also guide treatment options. As such, the presentation of neuropathic pain in ESRD can present a challenging case. The authors aim to provide a review of available classes of medications and considerations for the treatment of neuropathic pain in ESRD. Summary: In this narrative review, the authors discuss important strategies and considerations for the treatment of neuropathic pain in ESRD, including the pathogenesis of neuropathic pain, physiological changes for consideration in ESRD patients, and disease-specific consideration for medication selection. Pharmacotherapeutic classes discussed include: anticonvulsants, antiarrhythmics, antidepressants, topicals, and opioids. Key Message: Pain management in ESRD patients requires careful assessment of drug-specific properties, accumulation, metabolism (presence of active/toxic metabolites), extraction by dialysis, and presence of drug - drug interactions. In the absence of pharmacokinetic data in ESRD patients, therapeutic window and potential risks should be factored in the decision making along with continued monitoring throughout therapy.
引用
收藏
页码:157 / 167
页数:11
相关论文
共 67 条
  • [1] Multiple interacting sites of ectopic spike electrogenesis in primary sensory neurons
    Amir, R
    Kocsis, JD
    Devor, M
    [J]. JOURNAL OF NEUROSCIENCE, 2005, 25 (10) : 2576 - 2585
  • [2] [Anonymous], 1986, Pain Suppl, V3, pS1
  • [3] [Anonymous], 2017, TRIL OXC PRECR INF
  • [4] [Anonymous], 2017, TOP TOP PRESCR INF
  • [5] [Anonymous], 2017, DEP VALPR AC PRECR I
  • [6] [Anonymous], 2015, MEX HYDR PRESCR INF
  • [7] [Anonymous], 2017, FLEC AC PRESCR INF
  • [8] Topical Analgesics in the Management of Acute and Chronic Pain
    Argoff, Charles E.
    [J]. MAYO CLINIC PROCEEDINGS, 2013, 88 (02) : 195 - 205
  • [9] Neurological complications in chronic kidney disease
    Arnold, Ria
    Issar, Tushar
    Krishnan, Arun V.
    Pussell, Bruce A.
    [J]. JRSM CARDIOVASCULAR DISEASE, 2016, 5
  • [10] Atkinson TJ, 2014, PRACT PAIN MANAG, V14