만성 구강안면통증의 조절을 위한 약물치료적 접근

Pharmacological approaches for the management of chronic orofacial pain

  • 정재광 (경북대학교 치과대학 구강내과학교실) ;
  • 변진석 (경북대학교 치과대학 구강내과학교실) ;
  • 최재갑 (경북대학교 치과대학 구강내과학교실)
  • Jung, Jae-Kwang (Department of Oral Medicine, School of Dentistry, Kyungpook National University) ;
  • Byun, Jin-Seok (Department of Oral Medicine, School of Dentistry, Kyungpook National University) ;
  • Choi, Jae-Kap (Department of Oral Medicine, School of Dentistry, Kyungpook National University)
  • 발행 : 2019.03.31

초록

Chronic orofacial pain is an umbrella term as a kind of painful regional syndromes to describe unremitting and prolonged pains in orofacial area. It is frequently characterized with the intractable pain without the proportionally corresponding tissue pathology over 3 months. Accordingly, it is difficult or almost impossible to establish the causally oriented treatment strategies in those cases, while multidisciplinary approaches were usually considered for preventing prolonged pain conditions from limiting daily life. Among a variety of approaches, pharmacological approach was clinically based on proper applications of several groups of drugs useful to relieve or alleviate pain. These drugs usually encompass several analgesics, muscle relaxants, anti-depressants, anticonvulsants and so on. Therefore, it is essential for dental clinician to be aware of the many peculiarities of these medications applied for management of chronic orofacial pain disorders. This review focused on the clinical considerations for the careful drug selection and application including dosages and adverse drug reactions.

키워드

참고문헌

  1. 민양기, 김승민. 신경병성 통증의 진단과 치료. 대한의사협회지2008;51:1139-1148 https://doi.org/10.5124/jkma.2008.51.12.1139
  2. Okeson JP. Bell's orofacial pains: the clinical management of orofacial pain, 2005, Quintessence Publishing Company Chicago, Ill, USA
  3. 조상훈. 라성호. 치과 개원의를 위한 약 처방 이야기, 2017, (주)예낭아이엔씨
  4. 대한안면통증 구강내과학회 편저. 구강내과학 제4편 구강안면통증과 측두하악장애, 2012, (주)예낭아이앤씨
  5. 임재영. 노인의 만성통증의 최신 약물 치료 지침. 2010 대한임상노인의학회 춘계학술대회 자료집2010:85-92
  6. Laskin DM, Greene CS, Hylander WL. Temporomandibular disorders: an evidence-based approach to diagnosis and treatment, 2006, Quintessence Publishing Company
  7. 이경규. 만성 통증 환자에서의 정신약물학적 치료. 대한정신약물학회지 2008;19:77-84
  8. 문동언. 만성 통증 환자에서 항우울제의 사용. 대한통증학회지2004;17;54-62
  9. Al-Quliti KW. Update on neuropathic pain treatment for trigeminal neuralgia. the pharmacological and surgical options. Neurosciences (Riyadh) 2015;20:107-114 https://doi.org/10.17712/nsj.2015.2.20140501
  10. Schmidt D, Elger CE. What is the evidence that oxcarbazepine and carbamazepine are distinctly different antiepileptic drugs? Epilepsy Behav 2004;5:627-635 https://doi.org/10.1016/j.yebeh.2004.07.004
  11. Canavero S, Bonicalzi V. Drug therapy of trigeminal neuralgia. Expert Rev Neurother 2006;6:429-440 https://doi.org/10.1586/14737175.6.3.429
  12. Grevert P, Albert LH, Goldstein A. Partial antagonism of placebo analgesia by naloxone. Pain 1983;16:129-143 https://doi.org/10.1016/0304-3959(83)90203-8
  13. Stockstill JW. The placebo effect. the placebo effect in the management of chronic myofascial pain: A review. J Am Coll Dent 1989;56:14-18