Assuntos
Infecções por Coronavirus/terapia , Disseminação de Informação/métodos , Internet , Doenças do Sistema Nervoso/terapia , Neurologia , Pneumonia Viral/terapia , Betacoronavirus , COVID-19 , Protocolos Clínicos , Infecções por Coronavirus/complicações , Humanos , Doenças do Sistema Nervoso/complicações , Pandemias , Pneumonia Viral/complicações , SARS-CoV-2RESUMO
Neuropathic pain management is challenging, and typically requires a multifaceted approach. There are several treatment options, both pharmacologic and nonpharmacologic. Of the available pharmacologic agents, those with the strongest supporting evidence include tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and certain antiseizure agents. There is emerging evidence for the use of cannabinoids, but conclusive studies are not available. Nonpharmacologic therapies that have been utilized in the management of neuropathic pain include acupuncture, massage therapy, and reflexology. Despite their use as adjunctive therapies in clinical practice, the current evidence supporting their use is not strong. For the management of neuropathic pain, combination therapies are generally employed. Additional studies for emerging therapies are still needed.
Assuntos
Terapia por Acupuntura , Analgésicos/uso terapêutico , Massagem , Neuralgia/terapia , Manejo da Dor/métodos , Humanos , Neuralgia/tratamento farmacológicoRESUMO
INTRODUCTION: Recent triptan development has focused on new administration methods and formulations, triptan combination therapies, treatment in menstrually related migraines, and novel serotonin receptor subtype agonists (5HTf). Areas covered: Clinical triptan research related to migraine was reviewed, analyzing EMBASE and PUBMED data bases from 01/01/2011 to 06/29/2016, with a focus on clinical trials of class 1 or 2 level of evidence. There have been advances in drug combination therapies, as well as administration devices that aid in ease of use, increase efficacy, and decrease adverse reactions. Some new agents and devices have similar or less efficacy compared to previous generic triptan formulations. New agents have action at the 5HTf receptor subtype, and avoid vascular side effects of classic 5Ht1b/d agonists, however adverse reactions may limit their clinic use. Long half-life triptans, frovatriptan and naratriptan, do appear to have good benefit in menstral related migraine. Expert opinion: Recent advances in triptan development can offer some advantages to migraine therapy and patient preferences, but have a much higher cost compared to individual generic triptan agents. In the coming years, triptan advances with high efficacy, limiting ADRs and cost are welcomed, in this regard the 5HT1b/d triptans are already well established.
