Guidelines of Diabetic Neuropathy Management-summary

Page 1

2013 Clinical Department Information ERMED

Pharmacy and Dug Center -

[ Summary of Management Guidelines of the most common Diabetic Neuropathic Complications]


29-Apr-13 10:20 PM

Summary of Management Guidelines of the most common Diabetic Neuropathic Complications Prepared & summarized by Mohammad M. Kamal Nawar (*) Clinical Pharmacist – ERMED

Management should be begin at the initial diagnosis of DM , because failure to diagnose diabetic polyneuropathy can lead to serious consequences , including disability and amputation. Management pathways 1- Slow progression of neuropathy (mainly: tight and stable glycemic control). 2- Therapies for symptomatic relief. Patient education Develop realistic diet for lowering glucose and minimizing fluctuations in BGL. 1234567-

Be active ( exercise regularly ) Maintain normal B.P. Stop Smoking. Keep an ideal BMI. Avoid burns and injuries. Wearing comfortable shoes. Vitamin B complex.

Egyptian Railway Medical Center, Clinical Pharmacy & DIC Department 2


29-Apr-13 10:20 PM

Level

Generic Name

Examples of trade drugs ( Egyptian Market )

Notes

[ 1 ] Diabetic Neuropathic Pain A B C D

E

Pregabalin

Lyrica, Kemerica, …. Gabapentin Conventin, gaptin, … Sodium valproate Depakin, convulex, .. Dextromethorphan Tussilar Morphine sulphate Tramadol Oxycodon Topical lidocaine

Case by case For chronic DNP & fibromyalgia In massive cases for deep PDN

In selected cases

[ 2 ] Diabetic Gastro-paresis A

B C

Erythromycin Cisapride Motipride,.. Metoclopramide Motilium,… Poly-Ethylin-Glycol 3350 Tegaserod Tegsoran, zeltrod, ...

In emergent cases & for limited duration due to CV unacceptable events

[ 3 ] Experimental Therapies Egyptian Railway Medical Center, Clinical Pharmacy & DIC Department 3


29-Apr-13 10:20 PM

A

Aldose reductase inhibitors :

B

Alerstatin Sorbinil Tolrestat Epralrestat Alpha lipoic acid

C

Actovegin

D

Spinal stimulators

Aren’t currently used in USA market, only used in Japan

Thiotex, thiotacid, ..

As antioxidant Improve DN symptoms & sensory functions

cord

Abbreviations DN: Diabetic Neuropathy B.P: Blood Pressure BMI: Body Mass Index DNP: Diabetic Neuropathic Pain PDN: Painful Diabetic Neuropathy CV: Cardio Vascular

Egyptian Railway Medical Center, Clinical Pharmacy & DIC Department 4


29-Apr-13 10:20 PM

References - Guidelines of American Academy of Neurology (AAN). - Guidelines of American Academy of Physical Medicine and Rehabilitation (AANEM). - Guidelines American Academy of Physical Medicine and Rehabilitation (AAPMR). - Guideline for the treatment of painful diabetic neuropathy (PDN).

(*) For detailed evidenced papers, kindly contact us.

Egyptian Railway Medical Center, Clinical Pharmacy & DIC Department 5


Turn static files into dynamic content formats.

Create a flipbook
Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.