Abstract:
:The traditional cornerstones of analgesic therapy for patients with acute pain have been oral therapies; however, all oral agents exhibit a variety of potentially dose-limiting or intolerable adverse effects in patients. Elderly patients and those with concomitant conditions already being managed with multiple systemic drugs may be particularly susceptible to systemic toxicities with oral analgesic therapies. Topical agents offer an alternative to oral modalities and can effectively treat patients with acute pain while offering lower systemic absorption and conferring little risk of systemic toxicity. The objective of this article is to review the therapeutic usefulness of available topical therapies in their most thoroughly investigated applications, the treatment of patients with acute musculoskeletal and herpetic pain. For example, although heating pads/wraps and cold packs are widely used to alleviate pain associated with sprains, strains, and contusions, evidence of the effectiveness of these methods is lacking. However, there are sufficient data supporting the use of various topical formulations of nonsteroidal anti-inflammatory drugs (NSAIDs) for these indications (ketoprofen gel or patch, ibuprofen gel or cream, and diclofenac gel or patch), and demonstrating markedly less patient risk of systemic toxicity than is associated with oral NSAID therapy. A ketoprofen patch was shown to be effective and well tolerated in the treatment of patients with tendinopathies. In the treatment of acute neck or low back pain, cold and heat therapies have demonstrated limited effectiveness for patients, and the efficacy of topical NSAIDs has not been established. Use of topical NSAID therapy has been useful in reducing acute-phase herpes zoster pain, and the lidocaine 5% patch has been shown to reduce acute herpetic pain intensity once lesions have healed (the patch cannot be applied to open skin lesions). Topical analgesics represent an alternative treatment modality for patients experiencing acute pain who cannot or choose not to take oral therapies.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
McCarberg B,D'Arcy Ydoi
10.1080/00325481.2013.1110567011subject
Has Abstractpub_date
2013-07-01 00:00:00pages
19-24issue
4 Suppl 1eissn
0032-5481issn
1941-9260journal_volume
125pub_type
杂志文章,评审abstract:OBJECTIVE:Chronic kidney disease is a global public health concern. Glomerular filtration rate (GFR) prediction based on serum creatinine is used to assess renal function in the elderly. The Cockcroft-Gault (CG) formula, based on body surface area (CG/BSA formula), and the Modified Diet and Renal Disease formula (MDRD ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2010.11.2221
更新日期:2010-11-01 00:00:00
abstract::Common dislocations that can usually be managed in the office include anterior dislocations of the shoulder, posterior dislocations of the elbow and joints of the fingers and toes, and lateral dislocations of the patella. A systematic approach based on an understanding of the mechanism of injury, roentgenographic docu...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714687
更新日期:1977-11-01 00:00:00
abstract::Hepatitis C virus (HCV) is responsible for most cases of non-A non-B hepatitis and is primarily spread by a parenteral route, although familial, sexual, and maternal transmission may occur rarely. Second-generation assays and the polymerase chain reaction facilitate detection of HCV infection. The association between ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 00:00:00
abstract::Preview Early diagnosis of sickle cell disease enables physicians to initiate prompt treatment and provide appropriate education and counseling for patients and their families. In this article, Dr Burdick reviews the management of major complications of the disorder, discusses the psychosocial impact, and examines the...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945940
更新日期:1994-12-01 00:00:00
abstract::Fever of unknown origin (FUO) remains a challenging clinical problem despite recent advances in diagnostic tools and techniques. Because primary care physicians are often the first ones to encounter a case of FUO, it is important that they be familiar with the best strategy and steps for confronting this problem initi...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2003.09.1497
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) are common functional bowel disorders. Patients with IBS-C or CIC often present with ≥ 1 comorbidity that coincides with either of these conditions. These comorbidities may make underappreciated contributions to the ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.03.2640
更新日期:2013-03-01 00:00:00
abstract::Infective endocarditis refers to infection of the endocardium or heart valves by microbes, resulting in tissue destruction. Clinical presentation is quite variable, and a high level of suspicion is essential for recognition. Diagnosis is dependent on identification of the causative agent in blood cultures. Cultures th...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1993.11701672
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVES:As the prevalence of peripheral artery disease (PAD) increases there is growing concern about the associated healthcare burden. This burden has not been well-characterized in high-risk patients with concurrent diabetes and/or acute coronary syndrome (ACS). The objective of this analysis was to assess comorbi...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1144447
更新日期:2016-01-01 00:00:00
abstract::Hyponatremia (serum sodium <135 mEq/L) is a common electrolyte disorder in community or hospitalized patients. Serum sodium levels should be corrected at a proper rate in patients with hyponatremia, since overcorrection of serum sodium levels is related to devastating neurologic consequences, such as the osmotic demye...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1186488
更新日期:2016-06-01 00:00:00
abstract::Two cases of Listeria monocytogenes infection in patients receiving immunosuppressive treatment after kidney transplantation are described. In the first, the infection, which occurred soon after transplantation and was accompanied by signs of mild chronic rejection, was the immediate cause of death. The other case occ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715622
更新日期:1980-12-01 00:00:00
abstract::Overactive bladder is a prevalent condition with bothersome symptoms that greatly impact health-related quality of life. Despite a multitude of treatment options, many patients go untreated or undertreated. This article addresses the contemporary management of overactive bladder, including behavioral and lifestyle mod...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2012.01.2523
更新日期:2012-01-01 00:00:00
abstract::With the US population aging steadily, herpes zoster represents a growing contributor to diminished quality of life. Dermatologic manifestations appear as immunity declines with age but rarely pose a significant threat, except in instances when ocular structures are involved. Pain is of more concern, because it usuall...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.06.1114
更新日期:2000-06-01 00:00:00
abstract::More than 70 medications have been implicated as a cause of drug-induced lupus. The condition most commonly manifests with arthralgias and fever. The most important laboratory feature is an elevated antinuclear antibody titer, which often corresponds to the presence of antihistone antibodies. Fortunately, the course o...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.09.83
更新日期:1996-09-01 00:00:00
abstract::Acute urinary retention often is secondary to obstruction of the bladder or distal genitourinary system, which may be induced by any of a number of medical or surgical conditions. Treatment varies according to the cause. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11715998
更新日期:1982-02-01 00:00:00
abstract::Increasing evidence has contraindicated extended radical dissection of pancreatic adenocarcinoma (PC). With the recent improvement of perioperative management techniques and multimodal treatment strategy for PC, concomitant major vessel resection and reconstruction has thus been aggressively attempted in association w...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2015.1032180
更新日期:2015-04-01 00:00:00
abstract::Inflammatory bowel disease (IBD) is difficult to diagnose, and differentiating between ulcerative colitis (UC) and Crohn's disease (CD) can be challenging. Overlapping symptoms of UC and CD often delay diagnosis, despite availability of endoscopic, radiologic, and histologic tools. This delay in diagnosis is quite com...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2010.07.2184
更新日期:2010-07-01 00:00:00
abstract::Neonatal circumcision continues to be a controversial subject. The American Academy of Pediatrics has revised its earlier policy, stating that newborn circumcision has potential benefits as well as risks and emphasizing the need to explain these issues to parents considering the procedure so that an informed decision ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701325
更新日期:1992-05-01 00:00:00
abstract::Hair analysis has important uses in screening for metal intoxication and exposure to environmental pollutants, as well as applications in forensic medicine. In addition, hair analysis has been hailed as the new "in" tool for diagnosis of nutritional deficiencies and chronic diseases, but data to support these applicat...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716248
更新日期:1982-11-01 00:00:00
abstract::Hand eczema continues to bedevil both patients and physicians. While appropriate and judicious intervention minimizes aggravation, discomfort, and inconvenience, recurrences are frequent. Treatment with corticosteroids is often effective for irritant dermatitis. Efforts to avoid the irritant, protect the hands, and us...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.01.276
更新日期:1998-01-01 00:00:00
abstract::Performing office surgery well is an art. You can accomplish this by being attentive to several factors. These include, but are not limited to, providing an office environment that is pleasant, restful, and happy; using proper lighting, instruments, and suture techniques; using gentle techniques for local infiltration...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698400
更新日期:1983-08-01 00:00:00
abstract::In most cases, the cause of facial paralysis can be determined on the basis of the clinical evaluation, and expensive diagnostic tests can be avoided. Because Bell's palsy is not always the cause, physicians need to be able to identify critical findings on history and physical examination that indicate an alternative ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.06.522
更新日期:1998-06-01 00:00:00
abstract::Bronchiectasis belongs to the family of chronic obstructive lung diseases, even though it is much less common than asthma, chronic bronchitis, or emphysema. Clinical features of these entities overlap significantly. The triad of chronic cough, sputum production, and hemoptysis always should bring bronchiectasis to min...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.07.607
更新日期:1999-07-01 00:00:00
abstract::In the evaluation of male and female infertility the history, family history, physical examination, and endocrine and gonadal functional evaluations are the most informative measures. The cause of the infertility is never found in some 17.5% of couples and in almost one fourth of males. In over one third of cases male...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715204
更新日期:1979-07-01 00:00:00
abstract::Preview Severe metabolic complications of diabetes mellitus are a common cause of morbidity and death in both type I and type II disease. The distinctions between diabetic ketoacidosis and hyperosmolar nonketotic state are clearly defined, and accurate recognition is important for proper treatment. This article focuse...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1996.11946141
更新日期:1996-06-01 00:00:00
abstract::Angina pectoris is a clinical diagnosis with various forms and manifestations. In many cases, the diagnosis can be made without expensive supplementary cardiovascular tests. In a given patient, the likelihood of significant coronary artery disease can be assessed clinically from such variables as age, sex, type of sym...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1984.11698713
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVE:To compare effects of raisin snacks with conventional snacks on glycemia and cardiovascular risk factors. MATERIALS AND METHODS:A 12-week, randomized, controlled trial compared 3-times-a-day consumption of raisins with intake of processed snacks on glycemia and cardiovascular risk factors. Men and women were...
journal_title:Postgraduate medicine
pub_type: 杂志文章,随机对照试验
doi:10.3810/pgm.2014.01.2723
更新日期:2014-01-01 00:00:00
abstract::An exploratory subgroup analysis of a prospective, randomized, double-blind, forced-titration study comparing the efficacy and safety of once-daily olmesartan medoxomil (OM) and losartan potassium (LOS) in patients with stage 1 or stage 2 hypertension is reported. After a 3- to 4-week placebo run-in period, eligible p...
journal_title:Postgraduate medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3810/pgm.2012.05.2549
更新日期:2012-05-01 00:00:00
abstract::Inhalation of pressurized 100% oxygen is a helpful adjunctive treatment for certain patients, because the increased oxygen carried by the blood to the tissue enhances new growth of microcirculation and, thus, healing. Patients with tissue breakdown after radiation therapy, refractory osteomyelitis, gas gangrene, soft-...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699267
更新日期:1986-02-01 00:00:00
abstract::Proximal gastric vagotomy without drainage is widely accepted in Great Britain and Europe but in the United States has been done mainly in university centers. The operation denervates the acid-secreting parietal cell mass of the stomach, preserving vagal innervation to the gastric antrum and extragastric abdominal vis...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714810
更新日期:1978-04-01 00:00:00
abstract::Despite a plethora of clinical guidelines and evidence outlining the efficacy of inhaled corticosteroids, these medications continue to be underused in the treatment of asthma. This article reviews the justification for prescribing inhaled steroids as first-line therapy, discusses indications for their use, and compar...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2001.05.924
更新日期:2001-05-01 00:00:00