Pain medicine : the official journal of the American Academy of Pain Medicine
-
The occurrence of diabetic peripheral neuropathy (DPN) is linked to poor glycemic control over time. While most people never develop diabetic peripheral neuropathic pain (DPNP) as a consequence of DPN, enough of them do that we must have effective options for the management of this disabling condition. ⋯ One of these medications, duloxetine has been established to significantly improve pain and to address depression by its reuptake inhibition of norepinephrine and serotonin. This article examines the epidemiology of DPNP, its underlying pathogenesis, necessary evaluation methods, and treatment options available with a focus on the role of duloxetine.
-
New treatment options for diabetic peripheral neuropathic pain (DPNP) have recently been developed, including two Food and Drug Administration (FDA) approved agents, duloxetine and pregabalin. As clinicians face a broader spectrum of efficacious treatments, side-effect profiles play an increasingly important role in the development of a pain management regimen. In this article we review the safety profile of agents commonly used in the treatment of DPNP.
-
Our case will demonstrate a safe and practical alternative location for an implantable drug delivery system (IDDS) pump. Traditionally, these pumps have been placed subcutaneously in the lower abdomen. We will describe the technique used for under the breast placement. ⋯ The retromammary location for the IDDS pump is a safe and aesthetically pleasing option for some patients. This location is a useful alternative for female cachectic patients, or patients with abdominal ostomies.