What is peripheral neuropathic pain due to? - ANS ✓Damage to, or
dysfunction of, peripheral nerves
What does peripheral neuropathic pain respond to? - ANS ✓both peripheral
and centrally acting pharmacologic therapies
Give examples of peripheral neuropathic pain - ANS ✓Diabetic neuropathic
pain, postherpetic neuralgia,
What is central neuropathic pain or central sensitization due to? - ANS
✓central disturbance in pain processing (diffuse hyperalgesia/ allodynia
What does central neuropathic pain or central sensitization respond to? -
ANS ✓neuroactive compounds that alter levels of neurotransmitters involved in
pain transmission, and responsive to nonpharmacologic therapies such as
exercise and CBT
What are examples of central neuropathic pain/ central sensitization? -
ANS ✓Fibromyalgia, IBS, TMJD, Tension headache
What is the combination of peripheral and central mechanism pain due to?
- ANS ✓involvement of both inflammatory or mechanical damage to the tissues
along with dysfunction in central pain processing
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How to treat a combination of peripheral and central mechanism-related
pain - ANS ✓need to treat all contributing mechanisms
Give examples of combination of peripheral/ central mechanism pain - ANS
✓low back pain, Rheumatologic diseases that develop into comorbid
fibromyalgia
List the Benzodiazepine Anxiolytics - ANS ✓Xanax, Valium, Ativan
List the labs for Benzodiazepine Anxiolytics - ANS ✓Monitor levels of TCA and
Dig with concurrent use of Benzos--may increase those levels. Long term: check
liver and CBC periodically.
Mech of Action of Benzodiazepine Anxiolytics - ANS ✓Binds to benzo
receptors on postsynaptic GABA-A neuron within CNS including limbic system
In case of Benzo OD, use what med? - ANS ✓Flumazinil
Pregnancy Risk for Benzo's - ANS ✓Contraindicated
What is a non-Benzo Anxiolytic? - ANS ✓Buspar
On what Neurotransmitters does Buspar work? - ANS ✓5HT1A and 5HT2
receptors, does not affect GABA receptors, moderate affinity for D2 receptors.
5HT1A partial agonist at pre and post synaptic receptors
Mechanism of action of Buspar - ANS ✓Enhanced serotonergic activity in
projections to the amygdala, PFC, Striatum, and thalamus
Side Effects of Buspar - ANS ✓Light headedness, headache, insomnia, nausea,
nervousness/restlessness
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