Analgésicos coadyuvantes para el tratamiento del dolor crónico
Palabras clave:
IMAOS (inhibidores de la monoaminooxidasa), SRI (Inhibidores de la recaptación de serotonina), inhibidores duales de la recaptación de serotonina y norepinefrina (SSNRI), NMDA (N-metil D aspartato), TC (triciclicos), ON (Oxido nítrico)Resumen
Desde hace varias décadas el descubrimiento de la efectividad para el tratamiento del dolor con medicamentos cuya creación tenía otros fines, abrió la puerta a nuevas oportunidades para disminuir el sufrimiento de los pacientes y mejorar su calidad de vida.
Los primeros medicamentos que se utilizaron fueron los antidepresivos tricíclicos y después se amplió al espectro a anticonvulsivantes, anestésicos, bifosfonatos, relajantes musculares, antidepresivos inhibidores específicos de la serotonina y norepinefrina entre otros.
A pesar de esto la eficacia para control del dolor es muy variable según el tipo de patología y en algunos casos de enfermedades asociadas. Por esta razón se debe hacer un análisis de cada paciente en particular para definir el medicamento adecuado y la necesidad de varios principios activos que se complementen entre sí. No se debe olvidar que la aproximación a un paciente con dolor, mas si éste es crónico, debe ser interdisciplinaria e involucrar el área de la salud mental y la rehabilitación para evitar complicaciones, mayores incapacidades y lograr la mejor adaptación social y laboral de los pacientes.
Referencias bibliográficas
1. Acevedo J.C., Amaya A., Casasola O., Chinchilla N., De Giorgis M., Florez S. et al. Guías para el diagnostico y el manejo del dolor neuropático: consenso de un grupo de expertos latinoamericanos. Rev. Iberoamericana del Dolor No. 2, 2008:15-46
2. Aguilera-Muñoz J, Arizaga-Cueta E., Carpio- Rodas A., Crump J., Diaz-Heredia F., Fernandez C.F. et al. Guías de práctica clínica del dolor neuropático. Rev Neurol 2005; 40 (5):303-316.
3. Arendt-Nielsen L, Brondum J, Staahl C, Graven-Nielsen T, Huggins J, Smart T et al. Effects of gabapentin on experimental somatic pain and temporal summation. Reg Anesth Pain Med, 2007;32(5):382-388.
4. Arnold Lesley M. Duloxetine and other antidepressants in the treatment of patients with fibromyalgia. Pain Medicine 2007:8(S2)
5. Barzallo C. Una nueva definición del dolor neuropático y un nuevo enfoque para guiar su diagnostico. Revista iberoamericana de dolor, 2008;3(1):52-56.
6. Bee L, Dickenson A. Neuropathic Pain: Multiple Mechanisms at Multiple Sites. Future Neurology, 2007;2(6):661-671.
7. Buvanendran A., Reuben S., Kroin J. Recent advances in nonopioid analgesics for acute pain management. Techniques in Regional Anaesthesia and Pain Management 2007;11:19-26.
8. Carville, SF. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis, 2008;67:536-541.
9. Chang V, Gonzalez P, Akunthota V. Evidenceinformed management of chronic low back pain with adjunctive analgesics. The Spine Journal, 2008;8:21-27.
10. Cole E. Diabetic Peripheral neuropathic pain: recognition and management. Pain Medicine 2007: 8(S2):27-32
11. Crump J, Griego J.M., Vargas.Gomez J.J., Rodriguez R., Leon M.X., Moyano J. et al. Guías de práctica clínica del dolor neuropático (I). Protocolo. Rev Neurol 2005;40 (4):229-236.
12. Curatol M, Arendt-Nielsen L., Petersen- Felix S. Evidence, mechanisms and clinical implications of central hypersensitivity in chronic pain after whiplash injury. Clin J Pain 2004;20:469-476. 13. Davis M.. What is new in neuropathic pain?. Support Care Cancer, 2006; Sept.
14. Dworkin R., Connor A., Backonja M., Farrar J., Finnerup N., Jensen T. et al. Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain 2007; 132:237-251.
15. Gallagher R. Management of Neuropathic Pain Traslating Mechanistic Advances and Evidence-based Research into Clinical Practice. Clin J Pain 2006;22:S2-S8.
16. Goldenberg D. Pharmacological treatment of fibromyalgia and other chronic musculoskeletal pain. Best Practice and Research Clinical Rheumatology 2007;21(3):499-511.
17. Gudin J. Advances in the pharmacologic treatment of chronic and breakthrough pain. 25th Annual Scientific Meeting of the American Pain Society 2006, May 3-6.
18. Guevara-Lopez U, Covarrubias-Gomez A, Garcia-Ramos G, Hernandez-Jimenez S. Parámetros de práctica para el manejo del dolor neuropático. Revista de investigación clínica. 2006, Vol 58 (2):126-138.
19. Gutierrez-Alvarez Angela, Beltran-Rodriguez Johnny, Moreno Carlos. Antiepileptic Drugs in Treatment of Pain Caused by Diabetic Neuropathy. J Pain Manage 2007;34(2):201- 208.
20. Harden, Norman. Chronic Neuropathic Pain Mechanisms, Diagnosis, and Treatment. The Neurologist, 2005;11:111-122.
21. Heir G, Karolchek S, Kalladka M, Vishwanath A, Gomes J, Hhatri R et al. Use of topical medication in orofacial neuropathic pain; a retrospective study. Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:466- 469.
22. Ho K. Botulinum toxin A for myofascial trigger point injection; A qualitative systematic review. Eur J Pain, 2007;(11):519-527.
23. Ihde S. The therapeutic use of botulinum toxin in cervical and maxillofacial conditions: an evidence-based review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:e1-e11.
24. Jackson II K. Pharmacotherapy for Neuropathic Pain. Pain Practice, 2006;6(1):27-33.
25. Jann, M, Slade J. Antidepressant agents for the treatment of chronic pain and depression. Pharmacotherapy, 2007;27(11):1571- 1587.
26. Kautio AL, Haanpaa M, Saarto T, Kalso E. Amitrityline in the treatment of chemotherapy- induced neuropathic symptoms. J Pain Manage 2008;35:31-39.
27. Keskinbora K., Ferit Pekel A., Aydinli I. Gabapentin and an opioid combination versus opioid alone for the management of neuropathic cancer pain; A randomizede open trial. J Pain Manage 2007;34 (2):183- 189.
28. Khoromi S., Patsalides A., Parada S., Salehi V., Meegan J., Max M. Topiramate in chronic lumbar radicular pain. The Journal of pain, 2005;6(12):829-836.
29. Kiefer R. Complete Recovery from intractable complex regional pain syndrome, CRPStype I, Following anesthetic ketamine and midazolam. Pain Practice 2007, vol 7 Issue 2:147-150.
30. Knotkova H., Pappagallo M. Adjuvant Analgesics. Med Clin N Am 2007;91:113- 124.
31. Lawson Kim. Are complex therapies required as pharmacological treatments of fibromyalgia?. Future Rheumatol, 2007;2(6):599-605. .
32. Lemming D., Sorensen J., Graven-Nielsen T., Lauber R., Arendt-Nielsen L., Gerdle B. Managing Chronic whiplash associated pain with a combination of low-dose opiod (remifentanil) and NMDA-antagonist (ketamine). European Journal of Pain 2007;11:719-732
33. Lino N, Vallejo M. Tratamiento del dolor neuropático: perspectiva farmacoeconomica. Rev. Iberoamericana del Dolor, 2008;2:47-50.
34. Malanga G. Evidence-informed management of chronic low back pain with nonsteroidal anti-inflamatory drugs, muscle relaxants and simple analgesics. The spine Journal, 2008;(8):173-184.
35. McKeage K. Treatment options for the management of diabetic painful neuropathy: best current evidence. Current Opinion in Neurology, 2007;20:553-557.
36. Patkar A, Masand P., Krulewicz S., Mannelli P., Peindl K., Beebe K. et al. A Randomized, Controlled, Trial of Controlled Release Paroxetine in Fibromyalgia. The American Journal of Medicine 2007;120:448-454.
37. Pritchett Y. et al. Duloxetine for the management of diabetic peripheral neuropathic pain: Response profile. Pain Medicine 2007; 8(5):397-409.
38. Raskin J., Wang F., Pritchett Y., Goldstein D. Duloxetine for patients with diabetic peripheral neuropathic pain: A 6-month open-label safety study. Pain Medicine 2006;7(5):373-385
39. Rintala D. Comparison of the effectiveness of amitriptyline and gabapentin on chronic neuropathic ain in persons with spinal cord injury. Arch Phys Med Rehabil, 2007; 88:1547-1560.
40. Robinson-Papp J., Simpson D. Safety profile of treatment in diabetic peripheral neuropathic pain. Pain Medicine, 2007; 8(S2):43- 49.
41. Sadosky A., McDermott A., Brandenburg N., Strauss M. A review of the epidemiology of painful diabetic peripheral neuropathy, postherpetic and less commonly studied neuropathic pain conditions. Pain Practice, 2008; 8:45-56.
42. Saper J. A Double-Bind, Randomized, Placebo- controlled Comparison of Botulinum Toxin Type A Injection Sites and doses in the prevention of Episodic Migraine. Pain Medicine, 2007;6:478-485.
43. Sharma A., Williams K., Raja S. Advances in treatment of complex regional pain syndrome: recent insights on a perplexing disease. Curr Opin Anaesthesiol 2006; 19:566-572.
44. Stanos S. Topical agents for the management of musculoskeletal pain. Journal of pain and symptom management. 2007: 33 (3):342- 355
45. Tiippana E. Do Surgical Patients Benefit from Perioperative Gabapentin/pregabalin? A systematic Review of Efficacy and safety. Anesth Analg, 2007; 104:1545-56.
46. Vranken J.H., Dijkgraaf M.G.W., Kruis M.R., Van der Vegt M.H., Hollmann M.W., Heesen M. Pregabalin in patients with central neuropa thic pain: A randomized doubleblind, placebo-controlled trial of a flexibledose regimen. Pain, 2008; 136:150-157.
47. Wernicke J., Wang F., Pritchett Y., Smith T., Raskin J., D´Souza D., et al. An open-label 52-week clinical extensión comparing duloxetine with routine in patients with diabetic peripheral neuropathic pain. Pain Medicine 2007:8(S2):503-513.
48. Wiffen PJ, Saarto T. Antidepresivos para el dolor neuropático. La biblioteca Cochrane Plus, 2006 Número 1.
49. Wu C.. An update on the treatment of postherpetic neuralgia. The Journal of Pain. 2008; 9(S1):19-30.
50. Wu E, Birnbaum H, Mareva M, Le K, Robinson R, Rosen A et al. Cost-effectiveness of duloxetine versus routine treatment for U.S. patients with diabetic peripheral neuropathic pain. The Journal of pain, Vol 7, No. 6, 2006:399-407
51. Wu S., Wrobel J., Armstrong D. Assesing the impact of pharmacologic intervention on the quality of life in diabetic peripheral neuropathic pain and fibromyalgia. Pain Medicine 2007: 8(S2): 33-42
2. Aguilera-Muñoz J, Arizaga-Cueta E., Carpio- Rodas A., Crump J., Diaz-Heredia F., Fernandez C.F. et al. Guías de práctica clínica del dolor neuropático. Rev Neurol 2005; 40 (5):303-316.
3. Arendt-Nielsen L, Brondum J, Staahl C, Graven-Nielsen T, Huggins J, Smart T et al. Effects of gabapentin on experimental somatic pain and temporal summation. Reg Anesth Pain Med, 2007;32(5):382-388.
4. Arnold Lesley M. Duloxetine and other antidepressants in the treatment of patients with fibromyalgia. Pain Medicine 2007:8(S2)
5. Barzallo C. Una nueva definición del dolor neuropático y un nuevo enfoque para guiar su diagnostico. Revista iberoamericana de dolor, 2008;3(1):52-56.
6. Bee L, Dickenson A. Neuropathic Pain: Multiple Mechanisms at Multiple Sites. Future Neurology, 2007;2(6):661-671.
7. Buvanendran A., Reuben S., Kroin J. Recent advances in nonopioid analgesics for acute pain management. Techniques in Regional Anaesthesia and Pain Management 2007;11:19-26.
8. Carville, SF. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis, 2008;67:536-541.
9. Chang V, Gonzalez P, Akunthota V. Evidenceinformed management of chronic low back pain with adjunctive analgesics. The Spine Journal, 2008;8:21-27.
10. Cole E. Diabetic Peripheral neuropathic pain: recognition and management. Pain Medicine 2007: 8(S2):27-32
11. Crump J, Griego J.M., Vargas.Gomez J.J., Rodriguez R., Leon M.X., Moyano J. et al. Guías de práctica clínica del dolor neuropático (I). Protocolo. Rev Neurol 2005;40 (4):229-236.
12. Curatol M, Arendt-Nielsen L., Petersen- Felix S. Evidence, mechanisms and clinical implications of central hypersensitivity in chronic pain after whiplash injury. Clin J Pain 2004;20:469-476. 13. Davis M.. What is new in neuropathic pain?. Support Care Cancer, 2006; Sept.
14. Dworkin R., Connor A., Backonja M., Farrar J., Finnerup N., Jensen T. et al. Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain 2007; 132:237-251.
15. Gallagher R. Management of Neuropathic Pain Traslating Mechanistic Advances and Evidence-based Research into Clinical Practice. Clin J Pain 2006;22:S2-S8.
16. Goldenberg D. Pharmacological treatment of fibromyalgia and other chronic musculoskeletal pain. Best Practice and Research Clinical Rheumatology 2007;21(3):499-511.
17. Gudin J. Advances in the pharmacologic treatment of chronic and breakthrough pain. 25th Annual Scientific Meeting of the American Pain Society 2006, May 3-6.
18. Guevara-Lopez U, Covarrubias-Gomez A, Garcia-Ramos G, Hernandez-Jimenez S. Parámetros de práctica para el manejo del dolor neuropático. Revista de investigación clínica. 2006, Vol 58 (2):126-138.
19. Gutierrez-Alvarez Angela, Beltran-Rodriguez Johnny, Moreno Carlos. Antiepileptic Drugs in Treatment of Pain Caused by Diabetic Neuropathy. J Pain Manage 2007;34(2):201- 208.
20. Harden, Norman. Chronic Neuropathic Pain Mechanisms, Diagnosis, and Treatment. The Neurologist, 2005;11:111-122.
21. Heir G, Karolchek S, Kalladka M, Vishwanath A, Gomes J, Hhatri R et al. Use of topical medication in orofacial neuropathic pain; a retrospective study. Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:466- 469.
22. Ho K. Botulinum toxin A for myofascial trigger point injection; A qualitative systematic review. Eur J Pain, 2007;(11):519-527.
23. Ihde S. The therapeutic use of botulinum toxin in cervical and maxillofacial conditions: an evidence-based review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:e1-e11.
24. Jackson II K. Pharmacotherapy for Neuropathic Pain. Pain Practice, 2006;6(1):27-33.
25. Jann, M, Slade J. Antidepressant agents for the treatment of chronic pain and depression. Pharmacotherapy, 2007;27(11):1571- 1587.
26. Kautio AL, Haanpaa M, Saarto T, Kalso E. Amitrityline in the treatment of chemotherapy- induced neuropathic symptoms. J Pain Manage 2008;35:31-39.
27. Keskinbora K., Ferit Pekel A., Aydinli I. Gabapentin and an opioid combination versus opioid alone for the management of neuropathic cancer pain; A randomizede open trial. J Pain Manage 2007;34 (2):183- 189.
28. Khoromi S., Patsalides A., Parada S., Salehi V., Meegan J., Max M. Topiramate in chronic lumbar radicular pain. The Journal of pain, 2005;6(12):829-836.
29. Kiefer R. Complete Recovery from intractable complex regional pain syndrome, CRPStype I, Following anesthetic ketamine and midazolam. Pain Practice 2007, vol 7 Issue 2:147-150.
30. Knotkova H., Pappagallo M. Adjuvant Analgesics. Med Clin N Am 2007;91:113- 124.
31. Lawson Kim. Are complex therapies required as pharmacological treatments of fibromyalgia?. Future Rheumatol, 2007;2(6):599-605. .
32. Lemming D., Sorensen J., Graven-Nielsen T., Lauber R., Arendt-Nielsen L., Gerdle B. Managing Chronic whiplash associated pain with a combination of low-dose opiod (remifentanil) and NMDA-antagonist (ketamine). European Journal of Pain 2007;11:719-732
33. Lino N, Vallejo M. Tratamiento del dolor neuropático: perspectiva farmacoeconomica. Rev. Iberoamericana del Dolor, 2008;2:47-50.
34. Malanga G. Evidence-informed management of chronic low back pain with nonsteroidal anti-inflamatory drugs, muscle relaxants and simple analgesics. The spine Journal, 2008;(8):173-184.
35. McKeage K. Treatment options for the management of diabetic painful neuropathy: best current evidence. Current Opinion in Neurology, 2007;20:553-557.
36. Patkar A, Masand P., Krulewicz S., Mannelli P., Peindl K., Beebe K. et al. A Randomized, Controlled, Trial of Controlled Release Paroxetine in Fibromyalgia. The American Journal of Medicine 2007;120:448-454.
37. Pritchett Y. et al. Duloxetine for the management of diabetic peripheral neuropathic pain: Response profile. Pain Medicine 2007; 8(5):397-409.
38. Raskin J., Wang F., Pritchett Y., Goldstein D. Duloxetine for patients with diabetic peripheral neuropathic pain: A 6-month open-label safety study. Pain Medicine 2006;7(5):373-385
39. Rintala D. Comparison of the effectiveness of amitriptyline and gabapentin on chronic neuropathic ain in persons with spinal cord injury. Arch Phys Med Rehabil, 2007; 88:1547-1560.
40. Robinson-Papp J., Simpson D. Safety profile of treatment in diabetic peripheral neuropathic pain. Pain Medicine, 2007; 8(S2):43- 49.
41. Sadosky A., McDermott A., Brandenburg N., Strauss M. A review of the epidemiology of painful diabetic peripheral neuropathy, postherpetic and less commonly studied neuropathic pain conditions. Pain Practice, 2008; 8:45-56.
42. Saper J. A Double-Bind, Randomized, Placebo- controlled Comparison of Botulinum Toxin Type A Injection Sites and doses in the prevention of Episodic Migraine. Pain Medicine, 2007;6:478-485.
43. Sharma A., Williams K., Raja S. Advances in treatment of complex regional pain syndrome: recent insights on a perplexing disease. Curr Opin Anaesthesiol 2006; 19:566-572.
44. Stanos S. Topical agents for the management of musculoskeletal pain. Journal of pain and symptom management. 2007: 33 (3):342- 355
45. Tiippana E. Do Surgical Patients Benefit from Perioperative Gabapentin/pregabalin? A systematic Review of Efficacy and safety. Anesth Analg, 2007; 104:1545-56.
46. Vranken J.H., Dijkgraaf M.G.W., Kruis M.R., Van der Vegt M.H., Hollmann M.W., Heesen M. Pregabalin in patients with central neuropa thic pain: A randomized doubleblind, placebo-controlled trial of a flexibledose regimen. Pain, 2008; 136:150-157.
47. Wernicke J., Wang F., Pritchett Y., Smith T., Raskin J., D´Souza D., et al. An open-label 52-week clinical extensión comparing duloxetine with routine in patients with diabetic peripheral neuropathic pain. Pain Medicine 2007:8(S2):503-513.
48. Wiffen PJ, Saarto T. Antidepresivos para el dolor neuropático. La biblioteca Cochrane Plus, 2006 Número 1.
49. Wu C.. An update on the treatment of postherpetic neuralgia. The Journal of Pain. 2008; 9(S1):19-30.
50. Wu E, Birnbaum H, Mareva M, Le K, Robinson R, Rosen A et al. Cost-effectiveness of duloxetine versus routine treatment for U.S. patients with diabetic peripheral neuropathic pain. The Journal of pain, Vol 7, No. 6, 2006:399-407
51. Wu S., Wrobel J., Armstrong D. Assesing the impact of pharmacologic intervention on the quality of life in diabetic peripheral neuropathic pain and fibromyalgia. Pain Medicine 2007: 8(S2): 33-42
Cómo citar
1.
Fuentes Dávila NO. Analgésicos coadyuvantes para el tratamiento del dolor crónico. Rev. Colomb. Med. Fis. Rehabil. [Internet]. 19 de abril de 2012 [citado 20 de abril de 2024];20(1):33-44. Disponible en: https://revistacmfr.org/index.php/rcmfr/article/view/30
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