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Pain Management

Main:
Pain management plays a large role in almost every patient’s treatment, making it an important topic at the pharmacy. Pain can interfere with day-to-day life in many ways, and needs to be addressed in order to maximize a patient’s happiness and capabilities. Not all pain is the same, so prescribing the same medication for every patient isn’t going to work.

Customized therapies allow for optimal pain relief for a specific patient. Using a specially compounded pain medication means that you’re getting the exact pain relief made to fit your needs. Compounding a custom medication can mean switching the dosage form (using a cream versus a tablet), adjusting drug doses to necessary amounts, or using pain relieving drugs that you wouldn’t see used in a traditional pharmacy. Being able to fine tune pain medications gives patient’s exactly the relief they need in the most convenient way possible.

Neuropathic Pain:
Neuropathic pain is a complex event where a person experiences pain due to damage or stress to the nerves that conduct signals through the body. This is distinct from most other pains in that the nerves will be causing the pain signals, rather than detecting damage to a different part of the body. Because of the complexity of neuropathic pain, it’s hard for medical professionals to agree on what the best treatment is.

By compounding medications for neuropathic pain, pharmacists are able to use a wide variety of drugs that best fit the patient’s pain, formulated in convenient dosage forms. Traditional pharmacies have a limited number of options such as Gabapentin capsules, while compounding offers options like ketamine, amitriptyline, clonidine and more, available in multiple dosage forms.

Migraines:
Migraines can be extremely debilitating to anyone that experiences them, making the need for accurate treatment essential. Compounded migraine medications can be an ideal choice for patients requiring personalized therapy aimed to treat or prevent migraines. A common choice might include the combination of acetaminophen, isometheptene and dichloralphenazone, also known as Midrin®, which is no longer commercially available.

NSAIDS:
Non-Steroidal Anti-Inflammatory Drugs or NSAIDS are some of the most widely used pain medications today. They work to reduce swelling and inflammation in the body, which can provide immense pain relief for patients. Traditional pharmacies will likely carry oral Ibuprofen and Voltaren® topical gel, but only in a few set strengths. Choosing to compound an NSAID offers the advantage of more topical dosages forms, which can reduce the amount of side effects the patient experiences. It will also allow for dose adjustments to provide the optimal relief for the patient. Common formulations often include diclofenac or ketoprofen, sometimes in combination with other pain relieving medications.

Topicals Anesthetics:
Pain comes in many forms, but it’s very common for patients to experience pain at or under the skin. Topical anesthetics can numb the nerves of these areas to help manage any localized pain. Compounding is an optimal way to receive topical medications due to the ability to customize things like the amount applied, consistency, active ingredients, and time spent on the skin. Popular products are usually creams with some combination of benzocaine, lidocaine, and tetracaine.

Topical Opioids:
Opioids are a common class of medications that block the transmission of pain signals through the body. Currently in medicine there is considered to be an ‘Opioid Crisis’ due to the overuse of opioids and the related problems due to their side effect of sedation and slowed breathing. Compounded opioids can be formulated as topical medications, which subvert many of the problems and side effects associated with opioids.

Iontophoresis/Phonophoresis:
Most topical medications found in a traditional pharmacy will have a standard recipe that will work for a large amount of patients, but not necessarily all. Some formulations will require extra considerations in order to help deliver the drug to the patients. Iontophoresis is the practice of adding an ionic drug or compound to the topical medication in order to help increase how much penetrates the skin. Phonophoresis on the other hand is where a specially formulated topical drug will be administered on the skin with the help of a pulse producing ultrasound device.