title: Pharmacologic Treatment of Pain.
abstract: Adolescents and children are frequently affected by chronic pain conditions that can lead to disability and distress. The best approach to evaluation and treatment of these conditions involves use of the biopsychosocial model, which includes use of medication management. Chronic pain conditions are treated pharmacologically with a number of different medication classes via several routes of administration as drug delivery systems have progressed. These include anti-inflammatory drugs, muscle relaxants, antiepileptic medicines, antidepressants, opioids, and local anesthetics. Most are prescribed without regulatory body approval to treat specific pain syndromes as data to support their use are sparse. Medical decision making is guided by experience, empiric evidence, extrapolation from adult studies, and matching medication classes with the theorized mechanism of the pain condition. It is not recommended that nonpain practitioners prescribe opioid medications for treatment of chronic pain conditions, and pain management practitioners should seek to minimize their use. The appropriate and commonly used medications for pain conditions are presented in this narrative review.
authors.affiliation: Department of Anesthesiology, Frank Netter School of Medicine, Quinnipiac University, North Haven, CT; Department of Anesthesiology, Connecticut Children's Medical Center, Hartford, CT; Department of Anesthesiology, University of Connecticut School of Medicine, Farmington, CT; Division of Pain and Palliative Medicine, Connecticut Children's Medical Center, Hartford, CT; Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT. Electronic address: Emathew@connecticutchildrens.org.
authors.forename: Eapen
authors.initials: E
authors.lastname: Mathew
authors.affiliation: Department of Anesthesiology, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Department of Anesthesiology, Children's Hospital of Los Angeles, Los Angeles, CA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Kim
authors.affiliation: Division of Pain and Palliative Medicine, Connecticut Children's Medical Center, Hartford, CT; Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT.
authors.forename: William
authors.initials: W
authors.lastname: Zempsky
mesh_terms: D000293:Adolescent; D000700:Analgesics / Q000627:therapeutic use; D002648:Child; D006801:Humans; D010146:Pain / Q000188:drug therapy*
chemical_list: D000700:Analgesics