TREATMENT OF POSTHERPETIC NEURALGIA
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.29021/spdv.70.4.98 |
Resumo: | Postherpetic Neuralgia (PHN) is a common complication of acute Herpes Zoster, particularly in elderly pa- tients. Being a complex disorder of difficult control, experts have been trying to establish guidelines for pharmacological treatment of PHN. Recently, the European Federation of Neurological Societies (EFNS) gathered one of these work groups with this same purpose. In this paper, the authors intend to review and update this subject discussing the role of drugs like antivirals, antidepressants, certain anticonvulsants (gabapentin and pregabalin) and topical lidocaíne, whose therapeutic efficacy is well established in PHN. The role of opioids and capsaicin is also subject of reflection, as well as certain thera- peutic strategies recently identified as promising alternative options. Among these, the authors highlight transcutaneous electrical nerve stimulation (TNS), botulinum toxin and inhibitors of tumor necrosis factor alpha. It is widely recognized that control of pain in PHN often proves to be a challenge, requiring a delicate balance between therapeutic efficacy and side effects commonly experienced by an elderly population, often polymedicated and with multiple comorbidities. KEYWORDS – Drug therapy; Combination; Neuralgia, Postherpetic/drug therapy; Guideline. |
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TREATMENT OF POSTHERPETIC NEURALGIATRATAMENTO DA NEVRALGIA PÓS-HERPÉTICAPostherpetic Neuralgia (PHN) is a common complication of acute Herpes Zoster, particularly in elderly pa- tients. Being a complex disorder of difficult control, experts have been trying to establish guidelines for pharmacological treatment of PHN. Recently, the European Federation of Neurological Societies (EFNS) gathered one of these work groups with this same purpose. In this paper, the authors intend to review and update this subject discussing the role of drugs like antivirals, antidepressants, certain anticonvulsants (gabapentin and pregabalin) and topical lidocaíne, whose therapeutic efficacy is well established in PHN. The role of opioids and capsaicin is also subject of reflection, as well as certain thera- peutic strategies recently identified as promising alternative options. Among these, the authors highlight transcutaneous electrical nerve stimulation (TNS), botulinum toxin and inhibitors of tumor necrosis factor alpha. It is widely recognized that control of pain in PHN often proves to be a challenge, requiring a delicate balance between therapeutic efficacy and side effects commonly experienced by an elderly population, often polymedicated and with multiple comorbidities. KEYWORDS – Drug therapy; Combination; Neuralgia, Postherpetic/drug therapy; Guideline. A Nevralgia Pós-Herpética (NPH) é uma complicação frequente da infecção por herpes zoster, espe- cialmente em doentes idosos. Por ser uma patologia complexa e de difícil controlo, peritos têm-se reunido com o propósito de estabelecer guidelines de tratamento farmacológico da NPH. Recentemente a European Federation of Neurological Societies (EFNS) juntou um desses grupos com este mesmo objectivo. Neste trabalho, os autores pre- tendem fazer uma revisão e actualização do tema, discutindo o papel de fármacos, nomeadamente os antivirais, antidepressivos tricíclicos, alguns anticonvulsivantes (gabapentina e pregabalina) e a lidocaína tópica, cuja eficácia terapêutica na NPH está bem estabelecida. A importância dos opióides e da capsaicina é também objecto de reflexão, bem como de algumas terapêuticas recentemente apontadas como possíveis alternativas. Dentro destas destacamos a estimulação eléctrica transcutânea nervosa (TNS), a toxina botulínica e os inibidores do factor de necrose tumoral alfa. É largamente reconhecido que o controlo da dor na NPH revela-se frequentemente um desafio, exigindo um frágil equilíbrio entre a eficácia terapêutica e os efeitos secundários muitas vezes sentidos por uma população que, na maioria das vezes, é idosa, encontra-se sob politerapia e apresenta múltiplas comorbilidades. PALAVRAS-CHAVE – Nevralgia Pós-Herpética; Guideline; Tratamento farmacológico. Sociedade Portuguesa de Dermatologia e Venereologia2013-04-20T00:00:00Zjournal articleinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.29021/spdv.70.4.98oai:ojs.revista.spdv.com.pt:article/98Journal of the Portuguese Society of Dermatology and Venereology; Vol 70 No 4 (2012): Outubro-Dezembro; 451-457Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 70 n. 4 (2012): Outubro-Dezembro; 451-4572182-24092182-2395reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spdv.com.pt/index.php/spdv/article/view/98https://doi.org/10.29021/spdv.70.4.98https://revista.spdv.com.pt/index.php/spdv/article/view/98/99Teotónio, RuteBrinca, AnaCardoso, José CarlosRodrigues, Brunoinfo:eu-repo/semantics/openAccess2022-10-06T12:34:40Zoai:ojs.revista.spdv.com.pt:article/98Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:10:41.312356Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
TREATMENT OF POSTHERPETIC NEURALGIA TRATAMENTO DA NEVRALGIA PÓS-HERPÉTICA |
title |
TREATMENT OF POSTHERPETIC NEURALGIA |
spellingShingle |
TREATMENT OF POSTHERPETIC NEURALGIA Teotónio, Rute |
title_short |
TREATMENT OF POSTHERPETIC NEURALGIA |
title_full |
TREATMENT OF POSTHERPETIC NEURALGIA |
title_fullStr |
TREATMENT OF POSTHERPETIC NEURALGIA |
title_full_unstemmed |
TREATMENT OF POSTHERPETIC NEURALGIA |
title_sort |
TREATMENT OF POSTHERPETIC NEURALGIA |
author |
Teotónio, Rute |
author_facet |
Teotónio, Rute Brinca, Ana Cardoso, José Carlos Rodrigues, Bruno |
author_role |
author |
author2 |
Brinca, Ana Cardoso, José Carlos Rodrigues, Bruno |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Teotónio, Rute Brinca, Ana Cardoso, José Carlos Rodrigues, Bruno |
description |
Postherpetic Neuralgia (PHN) is a common complication of acute Herpes Zoster, particularly in elderly pa- tients. Being a complex disorder of difficult control, experts have been trying to establish guidelines for pharmacological treatment of PHN. Recently, the European Federation of Neurological Societies (EFNS) gathered one of these work groups with this same purpose. In this paper, the authors intend to review and update this subject discussing the role of drugs like antivirals, antidepressants, certain anticonvulsants (gabapentin and pregabalin) and topical lidocaíne, whose therapeutic efficacy is well established in PHN. The role of opioids and capsaicin is also subject of reflection, as well as certain thera- peutic strategies recently identified as promising alternative options. Among these, the authors highlight transcutaneous electrical nerve stimulation (TNS), botulinum toxin and inhibitors of tumor necrosis factor alpha. It is widely recognized that control of pain in PHN often proves to be a challenge, requiring a delicate balance between therapeutic efficacy and side effects commonly experienced by an elderly population, often polymedicated and with multiple comorbidities. KEYWORDS – Drug therapy; Combination; Neuralgia, Postherpetic/drug therapy; Guideline. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-04-20T00:00:00Z |
dc.type.driver.fl_str_mv |
journal article info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.29021/spdv.70.4.98 oai:ojs.revista.spdv.com.pt:article/98 |
url |
https://doi.org/10.29021/spdv.70.4.98 |
identifier_str_mv |
oai:ojs.revista.spdv.com.pt:article/98 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spdv.com.pt/index.php/spdv/article/view/98 https://doi.org/10.29021/spdv.70.4.98 https://revista.spdv.com.pt/index.php/spdv/article/view/98/99 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Dermatologia e Venereologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Dermatologia e Venereologia |
dc.source.none.fl_str_mv |
Journal of the Portuguese Society of Dermatology and Venereology; Vol 70 No 4 (2012): Outubro-Dezembro; 451-457 Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 70 n. 4 (2012): Outubro-Dezembro; 451-457 2182-2409 2182-2395 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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