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Chapter 6 - Topicals

Topical: Lidocaine, Capsaicin, Diclofenac

from Part II - Common Categories of Pharmacologic Medications to Treat Chronic Pain

Published online by Cambridge University Press:  01 December 2023

By
Juyeon Kakazu  and
Elyse M. Cornett
Edited by
Omar Viswanath  and
Ivan Urits
Omar Viswanath
Affiliation:
Creighton University, Omaha
Ivan Urits
Affiliation:
Southcoast Brain & Spine Center, Wareham
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Summary

Oral medication has been the mainstay of therapy; however, the use of topical formulation for chronic pain can reduce serious systemic side effects caused by oral medications. Topical administration of medication via patches, gels, creams, ointments, and solutions can provide local anesthesia and bypass major organ system. Lidocaine is an amide-type local anesthetic agent stabilizing the neuronal membranes by inhibiting the ionic fluxes required for initiation and conduction of impulses. Capsaicin is a selective agonist for TRPV1 receptor expressed in afferent neuronal C fibers and Ad fibers resulting in loss of receptor functionality causing impaired local nociception.Diclofenac works via inhibition of prostaglandin synthesis by blocking COX-1 and COX-2.

Keywords

topical analgesicstopicallidocainecapsaicinTRPV1COX-1COX-2pain
Type
Chapter
Information
Cambridge Handbook of Pain Medicine , pp. 49 - 52
Publisher: Cambridge University Press
Print publication year: 2023

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References

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Sarbacker, GB. Topical Therapies for Chronic Pain Management: A Review of Diclofenac and Lidocaine. Postgrad Med. 2013;125(4 Suppl 1):25–33. Accessed November 5, 2021. www.uspharmacist.com/article/topical-therapies-for-chronic-pain-management-a-review-of-diclofenac-and-lidocaineGoogle Scholar
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