Complex Regional Pain Syndrome
CRPS is a Chronic pain condition affecting one ____ and typically after trauma
One Limb
The addition of this to the physical therapy program was seen to make a significant contribution to clinical recovery in CRPS Type 1
TENS Therapy
These products inhibit osteoclast activity
Bisphosphonates
Good evidence of efficacy in chronic pain with these classes of medications
Selective Serotonin Reuptake Inhibitors
Serotonin & Norepinephrine Reuptake Inhibitors
Which of the following is most consistent with sympathetic nervous system dysfunction in complex regional pain syndrome?
Skin color changes
Incidence is approximately
1-in-20,000 people
Anesthetic is injected into regional nerves to produce a numbing effect. Improves patient’s symptoms and mobility in affected area.
Sympathetic Nerve Blocks
This product use in patients with CRPS who have had symptoms for more than 6 months has little efficacy
Corticosteroid
This Anticonvulsant-First-Generation Agent Side Effects include: Dizziness, sedation, rarely aplastic anemia & other severe hypersensitivity reactions
Carbamazepine (TEGRETOL®, CARBATROL®)
The major receptor type that is involved in central sensitization in the pathophysiology of CRPS is?
NMDA (N-methyl-D-aspartate)
More common in
women than in men
Uses low intensity electrical impulses to trigger selected nerve fibers along spinal cord
Spinal Cord Stimulation
This Anesthetic agent doses reduced pain while improving quality of life and the ability to work
Ketamine
This Adjunctive Medication Used For Chronic Pain
Anticonvulsants-Second-Generation Agent Eight states have made this product a schedule V controlled substance and 12 other states require stricter reporting.
Gabapentin (NEURONTIN®)
Which of the following drugs is most likely to cause driving impairment
TCAs have antihistaminic and anticholinergic effects that may initially cause acute somnolence or sedation, resulting in driving impairment
Can occur at any age, but most frequent is
40 years old
A surgical procedure destroying nerves in the sympathetic nervous system
Surgical Sympathectomy
As an emerging therapy interferes with autoantibodies and down regulates proinflammatory cytokines
IVIG
This Adjunctive Medications Used For Chronic Pain
Corticosteroid agent is preferred, due to its long half-life and minimal mineralocorticoid effect
Dexamethasone
When compared with antidepressant effects of TCAs, the analgesic effects
The analgesic effects of TCAs tend to occur more rapidly (within a week of initiating therapy), at lower serum levels, and at lower doses than required to exert their antidepressant effects.
The location of CRPS varies from person to person, often affecting the extremities, occurring slightly more in the lower extremities
(+/- 60%)
This modality is more effective and less costly than other treatments for CRPS. Can reduce pain and improve mobility in CRPS Type 1
Physical Therapy
This Lose Dose agent may reduce glial inflammation
Naltrexone
This stimulant product at doses of 65mg- 200 mg may increase the analgesic effect of opioids, acetaminophen, aspirin, and NSAIDs.
Caffeine
A 54-year-old patient was recently started on fluoxetine but also normally taking acetaminophen, oxycodone, tizanidine, and aspirin. Which of the following complications should you be most concerned about when initiating fluoxetine
Among the SSRIs, it appears that fluoxetine has the greatest propensity to cause gastrointestinal side effects including peptic ulcer disease. Patients taking SSRI together with an NSAID, as in this case, can further increase with risk.