Case vignette: A 21 y/o has surgery for a condition expected to improve. He fills a discharge prescription for 5 days of an opioid at a standard dose. At 1-week follow-up with his family doctor for suture removal, he describes ongoing pain. Is a renewal of opioid appropriate, potentially dangerous, or both? Aggressive promotion of opioids for chronic non-cancer pain (CNCP) began in the … [Read more...]
Acetaminophen vs. NSAIDs during COVID-19 pandemic
TREATING FEVER AND PAIN in the time of COVID-19 Many people are asking doctors for information about whether it is safe to use NSAID drugs now. Examples of this drug class include ibuprofen (generic, Advil, Motrin), naproxen (generic, Aleve), diclofenac (generic, Voltaren, Arthrotec), celecoxib (Celebrex), meloxicam (Mobicox) and many others. Feeling an increase in your body temperature can … [Read more...]
[115] Cannabinoids for Chronic Pain
Canada's parliament legalized the recreational use of herbal cannabis (marijuana) in October 2018. The well-publicized limitations of clinical research and well-recognized side effects such as cannabis intoxication have not deterred people from seeking out and using herbal cannabis for chronic pain in increasing numbers. This is occurring with or without a physician’s authorization.1 In fact, half … [Read more...]
[105] Is cyclobenzaprine useful for pain?
Cyclobenzaprine is a tricyclic molecule discovered in 1956 that is structurally related to amitriptyline and imipramine. Evaluated first as a possible tranquilizer, it was noted to have atropine-like properties in animals.1 In Canada, Merck Frosst Research Laboratories envisaged cyclobenzaprine as a centrally active skeletal muscle relaxant.2 However, it was soon apparent that despite being … [Read more...]
