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==Overview==
==Overview==
There is no treatment for [disease name]; the mainstay of therapy is supportive care.
Pharmacologic medical therapy is recommended among patients with peripheral neuropathy. Peripheral neuropathy, caused by various central and peripheral [[nerve]] disorders, is especially problematic because of its severity, chronicity and resistance to simple [[analgesic]]s. According to the cause of the peripheral neuropathy, treatments vary from the choice drug, the dosage of drug and the time of the treatment. Treatments for peripheral neuropathy are generally palliative. Pharmacologic medical therapies for peripheral neuropathy include: Topical [[lidocaine]], [[Gabapentin]], [[pregabalin]], [[Amitriptyline]], [[Nortriptyline]], [[Imipramine|imipramine,]] mixed [[Serotonin-norepinephrine reuptake inhibitor|serotonin–norepinephrine reuptake inhibitors]], [[Tramadol]], [[Buprenorphine|buprenorphine,]] [[Oxycodone]], [[Morphine]], [[Hydrocodone]] and [[Codeine]].
 
OR
 
Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
 
OR
 
The majority of cases of [disease name] are self-limited and require only supportive care.
 
OR
 
[Disease name] is a medical emergency and requires prompt treatment.
 
OR
 
The mainstay of treatment for [disease name] is [therapy].
 
OR
The optimal therapy for [malignancy name] depends on the stage at diagnosis.
 
OR
 
[Therapy] is recommended among all patients who develop [disease name].
 
OR
 
Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
 
OR
 
Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
 
OR
 
Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
 
OR
 
Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].


==Medical Therapy==
==Medical Therapy==
*Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].  
*Pharmacologic medical therapy is recommended among patients with peripheral neuropathy.<ref name="pmid16880448">{{cite journal| author=Gilron I, Watson CP, Cahill CM, Moulin DE| title=Neuropathic pain: a practical guide for the clinician. | journal=CMAJ | year= 2006 | volume= 175 | issue= 3 | pages= 265-75 | pmid=16880448 | doi=10.1503/cmaj.060146 | pmc=1513412 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16880448  }} </ref>
*Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
*Peripheral neuropathy, caused by various central and peripheral [[nerve]] disorders, is especially problematic because of its severity, chronicity and resistance to simple [[analgesic]]s.<ref name="pmid16880448">{{cite journal| author=Gilron I, Watson CP, Cahill CM, Moulin DE| title=Neuropathic pain: a practical guide for the clinician. | journal=CMAJ | year= 2006 | volume= 175 | issue= 3 | pages= 265-75 | pmid=16880448 | doi=10.1503/cmaj.060146 | pmc=1513412 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16880448  }} </ref>
*Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
*According to the cause of the peripheral neuropathy, treatments vary from the choice drug, the dosage of drug and the time of the treatment.
*Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
*Treatments for peripheral neuropathy are generally palliative.
===Disease Name===
*Pharmacologic medical therapies for peripheral neuropathy include:<ref name="pmid16880448">{{cite journal| author=Gilron I, Watson CP, Cahill CM, Moulin DE| title=Neuropathic pain: a practical guide for the clinician. | journal=CMAJ | year= 2006 | volume= 175 | issue= 3 | pages= 265-75 | pmid=16880448 | doi=10.1503/cmaj.060146 | pmc=1513412 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16880448  }} </ref>
 
**Topical [[lidocaine]]<ref name="pmid22059196">{{cite journal| author=Delorme C, Navez ML, Legout V, Deleens R, Moyse D| title=Treatment of neuropathic pain with 5% lidocaine-medicated plaster: Five years of clinical experience. | journal=Pain Res Manag | year= 2011 | volume= 16 | issue= 4 | pages= 259-63 | pmid=22059196 | doi= | pmc=3202378 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22059196 }} </ref>
* '''1 Stage 1 - Name of stage'''
**[[Gabapentin]]<ref name="pmid29178034">{{cite journal| author=Fornasari D| title=Pharmacotherapy for Neuropathic Pain: A Review. | journal=Pain Ther | year= 2017 | volume= 6 | issue= Suppl 1 | pages= 25-33 | pmid=29178034 | doi=10.1007/s40122-017-0091-4 | pmc=5701897 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29178034  }} </ref>
** 1.1 '''Specific Organ system involved 1'''
**[[Pregabalin]]<ref name="pmid28292992">{{cite journal| author=Nishikawa T, Hasegawa K, Shintani D, Yano Y, Sato S, Yabuno A et al.| title=[Combination Therapy of Pregabalin with Tramadol for Treatment of Peripheral Neuropathy in Patients with Gynecological Cancer Receiving Taxane Containing Chemotherapy]. | journal=Gan To Kagaku Ryoho | year= 2017 | volume= 44 | issue= 3 | pages= 227-231 | pmid=28292992 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28292992  }} </ref>
*** 1.1.1 '''Adult'''
**[[Tricyclic antidepressants]]:<ref name="pmid17314585">{{cite journal| author=Berger A, Dukes E, Edelsberg J, Stacey B, Oster G| title=Use of tricyclic antidepressants in older patients with diabetic peripheral neuropathy. | journal=Clin J Pain | year= 2007 | volume= 23 | issue= 3 | pages= 251-8 | pmid=17314585 | doi=10.1097/AJP.0b013e31802f67dd | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17314585  }} </ref>
**** Preferred regimen (1): [[drug name]] 100 mg PO q12h for 10-21 days '''(Contraindications/specific instructions)''' 
***[[Amitriptyline]]
**** Preferred regimen (2): [[drug name]] 500 mg PO q8h for 14-21 days
***[[Nortriptyline]]
**** Preferred regimen (3): [[drug name]] 500 mg q12h for 14-21 days
***[[Imipramine]]
**** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days  
**Mixed [[Serotonin-norepinephrine reuptake inhibitor|serotonin–norepinephrine reuptake inhibitors]]<ref name="pmid24577146">{{cite journal| author=Aziz MT, Good BL, Lowe DK| title=Serotonin-norepinephrine reuptake inhibitors for the management of chemotherapy-induced peripheral neuropathy. | journal=Ann Pharmacother | year= 2014 | volume= 48 | issue= 5 | pages= 626-32 | pmid=24577146 | doi=10.1177/1060028014525033 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24577146  }} </ref><ref name="pmid20514212">{{cite journal| author=Marks DM, Shah MJ, Patkar AA, Masand PS, Park GY, Pae CU| title=Serotonin-norepinephrine reuptake inhibitors for pain control: premise and promise. | journal=Curr Neuropharmacol | year= 2009 | volume= 7 | issue= 4 | pages= 331-6 | pmid=20514212 | doi=10.2174/157015909790031201 | pmc=2811866 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20514212 }} </ref>
**** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
**[[Tramadol]]<ref name="pmid28292992">{{cite journal| author=Nishikawa T, Hasegawa K, Shintani D, Yano Y, Sato S, Yabuno A et al.| title=[Combination Therapy of Pregabalin with Tramadol for Treatment of Peripheral Neuropathy in Patients with Gynecological Cancer Receiving Taxane Containing Chemotherapy]. | journal=Gan To Kagaku Ryoho | year= 2017 | volume= 44 | issue= 3 | pages= 227-231 | pmid=28292992 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28292992 }} </ref>
**** Alternative regimen (3): [[drug name]] 500 mg PO q6h for 14–21 days
**[[Opioids]]:<ref name="pmid20571607">{{cite journal| author=Raffa RB, Pergolizzi JV, Segarnick DJ, Tallarida RJ| title=Oxycodone combinations for pain relief. | journal=Drugs Today (Barc) | year= 2010 | volume= 46 | issue= 6 | pages= 379-98 | pmid=20571607 | doi=10.1358/dot.2010.46.6.1470106 | pmc=4046166 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20571607 }} </ref>
*** 1.1.2 '''Pediatric'''
***[[Buprenorphine]]
**** 1.1.2.1 (Specific population e.g. '''children < 8 years of age''')
***[[Oxycodone]]
***** Preferred regimen (1): [[drug name]] 50 mg/kg PO per day q8h (maximum, 500 mg per dose) 
***[[Morphine]]
***** Preferred regimen (2): [[drug name]] 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
***[[Hydrocodone]]
***** Alternative regimen (1): [[drug name]]10 mg/kg PO q6h (maximum, 500 mg per day)
***[[Codeine]]
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
****1.1.2.2 (Specific population e.g. '<nowiki/>'''''children < 8 years of age'''''')
***** Preferred regimen (1): [[drug name]] 4 mg/kg/day PO q12h（maximum, 100 mg per dose）
***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose) 
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
** 1.2 '''Specific Organ system involved 2'''
*** 1.2.1 '''Adult'''
**** Preferred regimen (1): [[drug name]] 500 mg PO q8h
*** 1.2.2  '''Pediatric'''
**** Preferred regimen (1): [[drug name]] 50 mg/kg/day PO q8h (maximum, 500 mg per dose)
 
* 2 '''Stage 2 - Name of stage'''
** 2.1 '''Specific Organ system involved 1 '''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.1.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.1.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '<nowiki/>'''''(Contraindications/specific instructions)''''''
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] '''(for children aged ≥ 8 years)''' 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)
** 2.2 '<nowiki/>'''''Other Organ system involved 2''''''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.2.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days  
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.2.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)
 
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 16:09, 5 September 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Pharmacologic medical therapy is recommended among patients with peripheral neuropathy. Peripheral neuropathy, caused by various central and peripheral nerve disorders, is especially problematic because of its severity, chronicity and resistance to simple analgesics. According to the cause of the peripheral neuropathy, treatments vary from the choice drug, the dosage of drug and the time of the treatment. Treatments for peripheral neuropathy are generally palliative. Pharmacologic medical therapies for peripheral neuropathy include: Topical lidocaine, Gabapentin, pregabalin, Amitriptyline, Nortriptyline, imipramine, mixed serotonin–norepinephrine reuptake inhibitors, Tramadol, buprenorphine, Oxycodone, Morphine, Hydrocodone and Codeine.

Medical Therapy

References

  1. ↑ 1.0 1.1 1.2 Gilron I, Watson CP, Cahill CM, Moulin DE (2006). "Neuropathic pain: a practical guide for the clinician". CMAJ. 175 (3): 265–75. doi:10.1503/cmaj.060146. PMC 1513412. PMID 16880448.
  2. ↑ Delorme C, Navez ML, Legout V, Deleens R, Moyse D (2011). "Treatment of neuropathic pain with 5% lidocaine-medicated plaster: Five years of clinical experience". Pain Res Manag. 16 (4): 259–63. PMC 3202378. PMID 22059196.
  3. ↑ Fornasari D (2017). "Pharmacotherapy for Neuropathic Pain: A Review". Pain Ther. 6 (Suppl 1): 25–33. doi:10.1007/s40122-017-0091-4. PMC 5701897. PMID 29178034.
  4. ↑ 4.0 4.1 Nishikawa T, Hasegawa K, Shintani D, Yano Y, Sato S, Yabuno A; et al. (2017). "[Combination Therapy of Pregabalin with Tramadol for Treatment of Peripheral Neuropathy in Patients with Gynecological Cancer Receiving Taxane Containing Chemotherapy]". Gan To Kagaku Ryoho. 44 (3): 227–231. PMID 28292992.
  5. ↑ Berger A, Dukes E, Edelsberg J, Stacey B, Oster G (2007). "Use of tricyclic antidepressants in older patients with diabetic peripheral neuropathy". Clin J Pain. 23 (3): 251–8. doi:10.1097/AJP.0b013e31802f67dd. PMID 17314585.
  6. ↑ Aziz MT, Good BL, Lowe DK (2014). "Serotonin-norepinephrine reuptake inhibitors for the management of chemotherapy-induced peripheral neuropathy". Ann Pharmacother. 48 (5): 626–32. doi:10.1177/1060028014525033. PMID 24577146.
  7. ↑ Marks DM, Shah MJ, Patkar AA, Masand PS, Park GY, Pae CU (2009). "Serotonin-norepinephrine reuptake inhibitors for pain control: premise and promise". Curr Neuropharmacol. 7 (4): 331–6. doi:10.2174/157015909790031201. PMC 2811866. PMID 20514212.
  8. ↑ Raffa RB, Pergolizzi JV, Segarnick DJ, Tallarida RJ (2010). "Oxycodone combinations for pain relief". Drugs Today (Barc). 46 (6): 379–98. doi:10.1358/dot.2010.46.6.1470106. PMC 4046166. PMID 20571607.

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