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  • Print publication year: 2008
  • Online publication date: December 2009

Trigeminal neuralgia

from Chief complaints and diagnoses

Summary

Opioids remain the most commonly used, and most commonly recommended, treatment for acute (and acute-on-chronic) pancreatitis. Most of the opioids are acceptable, there are reasons to select the mixed agonist-antagonist buprenorphine. Buprenorphine appears to have advantages related to paucity of effect on Oddi's sphincter. There is conflicting information as to the role of NSAIDs in treating pancreatitis pain. One expert consensus panel included NSAIDs as a first-line treatment for flares of chronic pancreatitis. The cholecystokinin (CCK)-receptor antagonists proglumide and loxiglumide appear to be effective in ameliorating pain from acute exacerbations of pancreatitis. One study demonstrated improvement in both subjective and objective (laboratory) parameters. Given potent inhibitory effects on pancreatic secretion, somatostatin and its analog octreotide have been studied for use in pancreatitis. Prophylactic somatostatin may reduce the rate of pancreatitis after endoscopic retrograde cholangiopancreatography. However, the acute care indications for this drug class are less clear.

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