15^th Annual European Pharma Congress

Biography

Biography: Bimal Roy Krishna

Abstract

Pain management, an integral part of therapeutics and clinical medicine has evolved immensely over the years and now to a certain extent integrates prescribed and complementary and alternative medicine. The physiology and pathology of pain whether peripheral or central, involves nociception and transmission from the injured tissue-skin, muscle or viscera. Pain associated with trauma and terminal diseases requires aggressive control beyond the inhibition of the inflammatory mediators such as the prostaglandins; afferent fibers, spinal cord sensory cells and chemical mediators play a pivotal role. Pain management, which to a great extent is based on patient response and the pain scale, is associated with a Step-up approach relating to the type of pain and underlying pathophysiology. Traditionally, non-steroidal anti-inflammatory drugs have been the mainstay of treatment. However, failure of Nonsteroidal Anti-inflammatory Drugs (NSAID) to treat pain or more chronic conditions require a Step-up 1 approach which would then introduce the opioids which address central mechanisms and are also used to treat severe pain, particularly those associated with terminal illness and myocardial infarcts. The mechanisms of action of opioids are similar; however, they differ in pharmacokinetic parameters. Complementary and alternative medicine (CAM) has now become a widely accepted approach to pain management either with prescribed medications or as an alternative. That fact remains that the mechanism of action and pharmacokinetic and parameters of these agents are not fully elucidated. This presentation addresses the use of both prescribed medications and CAM in pain management.