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Pain Management

According to the American Pain Foundation, there are more than 50 million Americans suffering from chronic pain, or 25 million experiencing acute pain as a result of injury or surgery.  Plenty of options exist to ease aches. 

Topical Therapy
Many medications used orally can be prepared for direct topical application to the pain site.  When medications are administered transdermally, they are not absorbed through the gastrointestinal system and do not undergo first-pass hepatic metabolism; therefore, side effects associated with oral administration can often be avoided.  This delivery option also offers the patient with difficulty swallowing an alternative route of administration. 

Compound Care Pharmacy specializes in producing customized medications based on a prescribers order.  We routinely receive prescriptions to incorporate medications into transdermal gels, creams and ointments.  Optimal treatment can involve the use of medications that possess pain-relieving properties including; NSAIDs, muscle relaxants/anti-spasmatics, some antidepressants, anticonvulsants, antiarrhythmics, anesthetis, antiviral agents and NMDA antagonists.

Examples of medications used in specific conditions:
Inflammation (nsaid such as ketoprofen or diclofenac with or without lidocaine/tetracaine)
Musculoskeletal (nsaid, baclofen, cyclobenzaprine, lidocaine)
Neuropathies (gabapentin, nsaid, cyclobenzaprine, lidocaine with or without ketamine)
CRPS/RDS (ketamine, lidocaine, tetracaine)
Herpes Simplex/Varicella Zoster (ketoprofen, acyclovir, lidocaine)
Gout (ketoprofen, indomethacin, triamcinolone,lidocaine)
Nausea/Vomiting (promethazine)
Wound Care (nifedipine, verapamil, phenytoin)

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.

Capsule Therapy
Many times we receive prescriptions for pain management in capsule form according to the individual needs of the patient. 

Most often the medication is customized to meet one or more of the following criteria:
Change delivery to either sustained or immediate release form
Adjust narcotic dose to fit the patient’s need
Combine medications to enhance compliance
Add fillers to alleviate side effects (i.e.: fiber-constipation)
Alter mg’s of agents for safety concerns (i.e.; hydrocodone/acetaminophen – decrease level of acetaminophen due to liver toxicity concerns)

Topicals and Capsules are not the only delivery options available.  We also can customize medications into sublingual troches or lozenges, suppositories, oral suspensions, sprays, mouth rinses, and lollipops.

The following is a list of pain conditions for which we commonly compound medications:
  • Arthritis
  • Ankle Pain
  • Back Pain
  • Burning Foot Syndrome
  • Carpal Tunnel Syndrome
  • Gout
  • Diabetic Neuropathy
  • Fibromyalgia
  • Foot Pain
  • CRPS
    (Chronic Regional Pain Syndrome)
  • Head, Neck, and Facial Pain
  • Knee Pain
  • Migraines
  • Muscle Spasms
  • Neuropathic Pain
  • Post Herpetic Neuralgia
  • Shingles
  • Shoulder Pain
  • Tennis Elbow
  • TMJ/TMD
    (Temporomandibular Disorders)
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