RESUMO
Neuropathic pain of various etiologies is a frequent symptom in HIV-infected patients that is underdiagnosed and inadequately treated. It requires a multidisciplinary pain approach based on psychosocial factors, diet and exercise, etiologic treatment whenever possible, symptomatic medical treatment, and sometimes, interventional techniques. Medical treatment should be individualized and introduced gradually, with a mind to potential drug interactions. Neuropathic pain responds poorly to conventional analgesics, such as nonsteroidal antiinflammatory drugs and opiates; tricyclic antidepressants and anticonvulsants are the drugs of choice. Before establishing an analgesic treatment, possible drug interactions should be ruled out, mainly those occurring with antiretroviral agents.
Assuntos
Infecções por HIV/complicações , Doenças do Sistema Nervoso/etiologia , Manejo da Dor , Dor/etiologia , Algoritmos , HumanosRESUMO
El dolor neuropático en los pacientes con infección por VIH es un síntoma frecuente y de etiología múltiple que suele estar infradiagnosticado e infratratado. Exige un abordaje multidisciplinario e individualizado. Debemos hacer un tratamiento combinado del dolor basado en aspectos psicosociales, dieta y ejercicio, también tratamiento etiológico siempre que sea posible y tratamiento farmacológico sintomático e incluso recurrir a técnicas intervencionistas. El tratamiento farmacológico del dolor neuropático debe de ser individualizado y escalonado, teniendo en cuenta las posibles interacciones medicamentosas, sobre todo en los enfermos con VIH que reciben habitualmente mucha medicación de forma simultánea. Responde mal a los analgésicos convencionales como los antiinflamatorios no esteroideos y los opioides, y son los antidepresivos tricíclicos y los anticomiciales los fármacos de elección. Antes de instaurar un tratamiento analgésico hay que descartar las posibles interacciones medicamentosas, fundamentalmente con los antirretrovirales (AU)
Neuropathic pain of various etiologies is a frequent symptom in HIV-infected patients that is underdiagnosed and inadequately treated. It requires a multidisciplinary pain approach based on psychosocial factors, diet and exercise, etiologic treatment whenever possible, symptomatic medical treatment, and sometimes, interventional techniques. Medical treatment should be individualized and introduced gradually, with a mind to potential drug interactions. Neuropathic pain responds poorly to conventional analgesics, such as nonsteroidalanti inflammatory drugs and opiates; tricyclic antidepressants and anticonvulsants are the drugs of choice. Before establishing an analgesic treatment, possible drug interactions should be ruled out, mainly those occurring with antiretroviral agents (AU)
Assuntos
Humanos , Infecções por HIV/complicações , Neuralgia/tratamento farmacológico , Dor/tratamento farmacológico , Infecções por HIV/tratamento farmacológico , Analgésicos/uso terapêutico , Interações Medicamentosas , Antidepressivos Tricíclicos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Anticonvulsivantes/uso terapêuticoRESUMO
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