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Molecules 2018, 23(3), 681; https://doi.org/10.3390/molecules23030681

Transdermal and Topical Drug Administration in the Treatment of Pain

1
Department of Palliative Medicine, Poznan University of Medical Sciences, Osiedle Rusa 55, 61–645 Poznan, Poland
2
Department of Anesthesiology and Intensive Care, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland
3
Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College, 31-008 Krakow, Poland
4
Department of Anesthesiology and Intensive Therapy, University Hospital, 31-501 Krakow, Poland
*
Author to whom correspondence should be addressed.
Academic Editor: Silvia Schenone
Received: 30 January 2018 / Revised: 12 March 2018 / Accepted: 13 March 2018 / Published: 17 March 2018
(This article belongs to the Special Issue Medicinal Chemistry in Europe)
Full-Text   |   PDF [777 KB, uploaded 3 May 2018]   |  

Abstract

The comprehensive treatment of pain is multidimodal, with pharmacotherapy playing a key role. An effective therapy for pain depends on the intensity and type of pain, the patients’ age, comorbidities, and appropriate choice of analgesic, its dose and route of administration. This review is aimed at presenting current knowledge on analgesics administered by transdermal and topical routes for physicians, nurses, pharmacists, and other health care professionals dealing with patients suffering from pain. Analgesics administered transdermally or topically act through different mechanisms. Opioids administered transdermally are absorbed into vessels located in subcutaneous tissue and, subsequently, are conveyed in the blood to opioid receptors localized in the central and peripheral nervous system. Non–steroidal anti–inflammatory drugs (NSAIDs) applied topically render analgesia mainly through a high concentration in the structures of the joint and a provision of local anti–inflammatory effects. Topically administered drugs such as lidocaine and capsaicin in patches, capsaicin in cream, EMLA cream, and creams containing antidepressants (i.e., doxepin, amitriptyline) act mainly locally in tissues through receptors and/or ion channels. Transdermal and topical routes offer some advantages over systemic analgesic administration. Analgesics administered topically have a much better profile for adverse effects as they relieve local pain with minimal systemic effects. The transdermal route apart from the above-mentioned advantages and provision of long period of analgesia may be more convenient, especially for patients who are unable to take drugs orally. Topically and transdermally administered opioids are characterised by a lower risk of addiction compared to oral and parenteral routes. View Full-Text
Keywords: adverse effects; analgesics; pain; topical drugs; transdermal opioids adverse effects; analgesics; pain; topical drugs; transdermal opioids
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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MDPI and ACS Style

Leppert, W.; Malec–Milewska, M.; Zajaczkowska, R.; Wordliczek, J. Transdermal and Topical Drug Administration in the Treatment of Pain. Molecules 2018, 23, 681.

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