Léčba pacientů s bolestivou polyneuropatií
| Title in English | Treatment of painful neuropathies |
|---|---|
| Authors | |
| Year of publication | 2019 |
| Type | Article in Periodical |
| Magazine / Source | Farmakoterapeutická revue |
| MU Faculty or unit | |
| Citation | |
| Web | https://farmakoterapeutickarevue.cz/cs/lecba-pacientu-s-bolestivou-polyneuropatii |
| Keywords | polyneuropathy; neuropathic pain; therapy; diabetes mellitus; antidepressants; antiepileptics |
| Description | Treatment of patients with painful polyneuropathy includes: 1) identifying and, optionally, treating the causative factor of polyneuropathy, 2) treating peripheral neurogenic disability itself, and 3) treating neuropathic pain. The most common etiological factor of polyneuropathies in our conditions is diabetes mellitus. Influencing the peripheral neuropathy itself is more effective in demyelinating types of polyneuropathy, while the possibilities of pharmacological prevention or significant support for the regeneration of axonal involvement are very limited. In the treatment of neuropathic pain, antiepileptic drugs belonging to the [alphaa]2[delta] ligand family of voltage-controlled calcium channel subunits (gabapentin, pregabalin) and antidepressants from the serotonin and noradrenaline reuptake inhibitors (duloxetine, venlafaxine) or tricyclic antidepressants class are the first choice drugs. Tramadol or strong opioids can be used as second-line drugs and topically-applied drugs (capsaicin, lidocaine) in the case of localized pain. |
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