Pain management is crucial because uncontrolled pain prevents patients from living their daily lives to the fullest. Chronic pain may have many different causes factors, and therefore can be much more difficult to manage than acute pain. Chronic pain may require a more complex approach and creative use of medications to meet the specific needs of each patient.
Optimal treatment may involve the use of medications that possess pain-relieving properties, including some antidepressants, anticonvulsants, antiarrhythmics, anesthetics, antiviral agents and NMDA (N-methyl-D-aspartate) antagonists. NMDA-receptor antagonists, such as dextromethorphan and ketamine, can block pain transmission in dorsal horn spinal neurons, reduce nociception and decrease tolerance to and the need for opioid analgesics. By combining various agents which utilize different mechanisms to alter the sensation of pain, physicians have found that smaller concentrations of each medication can be used.
Many doctors and patients have found that compounded medications can be very beneficial for pain management. The ability for a compounding pharmacy to essentially create a new medication that doesn’t need to be ingested or swallowed, and which may have fewer side effects compared to oral traditional pills and IV medications, can be life changing for many patients.
Transdermal creams and gels can be to applied to the site of injury or pain and provide high local concentrations of medication directly to the problem area. (e.g., combinations of medications for neuropathic pain).Or, medications can be compounded in a base that will allow increased systemic absorption throughout the body. Side effects generally associated with oral dosages of the same medicines can often be avoided when the medications are used topically or transdermally. Studies suggest that there are no significant restrictions on the type of drug that can be incorporated into a properly compounded transdermal gel. This means that for treating many types of chronic pain, transdermal pain-relieving creams or gels could be the answer the doctor or patient is looking for.
Many physicians are unaware that many of their patients’ side effects and other problems encountered with commercially available pain medications can be rectified with compounded medications. This is usually because a doctor is not aware to the capabilities of a professional compounding pharmacist. However, topical and transdermal pain management approaches have wide popularity among health care providers and patients when they are used. Topical and transdermal preparations are often preferred to oral medications due to decreased side effects and the avoidance of first-pass hepatic metabolism, which means that the medication is not broken down by the liver before it reaches the problem area.
We work together with patients and practitioners to solve problems by customizing medications that meet the specific needs of each individual. When referring a patient to our compounding pharmacy for a particular problem, we anticipate questions and have many years of experience to draw from to help not only answer your questions, but also deliver a medication that will fit each patient’s specific needs. Please contact our compounding pharmacist to discuss the dosage form, strength, and medication or combination that is most appropriate for your patient.