365.3 🏥 內科專科考前版

365.3.1 Mechanistic Deep Dive

365.3.1.1 Pain Pathways

  • Nociceptors → DRG → spinal cord dorsal horn → spinothalamic tract → thalamus → cortex
  • Descending modulation (PAG, locus coeruleus, RVM)
  • Inhibitory neurotransmitters: opioids, GABA, glycine, serotonin, NE

365.3.1.2 Central Sensitization

  • NMDA receptor activation
  • ↑ excitability
  • Allodynia + hyperalgesia
  • Wind-up phenomenon

365.3.1.3 Neuropathic Pain Mechanisms

  • Sodium channel dysfunction (ectopic firing)
  • Glutamatergic signaling
  • Glial activation (microglia, astrocytes)
  • Cytokine release
  • Disinhibition (loss of GABA, glycine)

365.3.2 Recent Trials & Updates

365.3.2.1 Suzetrigine (Vertex VX-548)

  • Selective NaV1.8 inhibitor
  • Non-opioid for acute pain
  • FDA approved January 2025 (acute pain post-surgery)
  • Phase 3 trials positive

365.3.2.2 CGRP for Migraine

  • Detailed in Ch363

365.3.2.3 Buprenorphine for Chronic Pain

  • Partial agonist
  • Lower OD risk
  • Ceiling effect on respiratory depression
  • Useful for OUD + pain

365.3.2.4 Cannabis-Based Medications

  • Mixed evidence
  • Sativex (UK, Canada — MS spasticity)
  • Recreational legalization → research barriers
  • Adverse: cognitive, psychiatric

365.3.2.5 Ketamine Infusions

  • Low-dose IV
  • Refractory chronic pain
  • CRPS
  • Neuropathic
  • Dissociation, psychomimetic risks

365.3.2.6 Lasmiditan + Gepants (Migraine)

  • Detailed in Ch363

365.3.2.7 TRPV1 + TRPA1 Antagonists

  • Investigational
  • Capsaicin receptor + cold/menthol

365.3.3 High-Yield Specialist Points

365.3.3.1 Methadone in Chronic Pain

  • NMDA antagonist component
  • Useful in neuropathic refractory to other opioids
  • ECG before + during titration (QT)
  • Variable T1/2 (15-60 hr)
  • Slow titration required

365.3.3.2 Opioid-Induced Hyperalgesia

  • Paradoxical ↑ pain with ↑ opioid
  • Often misdiagnosed as tolerance
  • Distinguished by: spread of pain, diffuse, lower threshold
  • Treatment: opioid rotation, taper, NMDA antagonist (methadone, ketamine)

365.3.3.3 Opioid Rotation

  • For inadequate analgesia + intolerable side effects
  • Convert to MME
  • Reduce by 25-50% for incomplete cross-tolerance
  • Then titrate

365.3.3.4 Pain in Renal Failure

  • Avoid morphine (M6G accumulation)
  • Avoid codeine (active metabolites)
  • Avoid meperidine (normeperidine — seizures)
  • Safe: methadone, fentanyl, buprenorphine
  • Hydromorphone with caution

365.3.3.5 Pain in Liver Failure

  • Acetaminophen safe in moderate doses (3 g/d max)
  • NSAIDs avoid (renal, bleeding)
  • Opioids: ↓ doses, ↑ intervals (most undergo hepatic metabolism)
  • Tramadol: caution
  • Methadone: caution (variable metabolism)

365.3.3.6 Cancer Pain Approach

  • Identify nociceptive vs neuropathic vs mixed
  • WHO ladder + adjuvants
  • Strong opioids early if severe
  • Adjuvants for specific pain (bone — bisphosphonates, RT; neuropathic — gabapentinoids, TCAs)
  • Procedural — celiac plexus block (pancreatic), intrathecal pump (refractory)

365.3.3.7 Acute Pain Management

  • Multimodal best
  • Reduce opioid requirements
  • Combinations of acetaminophen + NSAID + opioid
  • Local anesthetic blocks
  • Suzetrigine (NaV1.8 — new 2025)

365.3.3.8 Chronic Low Back Pain

  • Multifactorial
  • NSAIDs first-line
  • Gabapentinoids (mixed evidence)
  • Duloxetine
  • PT, CBT
  • Opioids: limited evidence, risk > benefit chronic
  • Procedural: epidural injections, RFA

365.3.3.9 Fibromyalgia (Nociplastic)

  • Diagnostic criteria (2016 ACR)
  • Widespread pain + fatigue + sleep + cognitive
  • Treatment: aerobic exercise (best evidence), pregabalin, duloxetine, milnacipran (FDA-approved)
  • Avoid opioids

365.3.4 Pearls

  • Three pain types: nociceptive + neuropathic + nociplastic
  • WHO ladder still relevant
  • Minimize opioids, multimodal approach
  • Neuropathic: gabapentinoids + SNRIs + TCAs
  • Trigeminal neuralgia: carbamazepine
  • PHN prevention: Shingrix
  • MME ≥ 50 high risk
  • Suzetrigine (NaV1.8) 2025 non-opioid acute pain
  • Naloxone for OD
  • MAT for OUD: buprenorphine, methadone, naltrexone