A 70-year-old male with diabetic peripheral neuropathy reports a burning sensation in his feet. He also states, "Those pain pills make me feel funny and they don't help my pain, so I don't take them
" Which of the following is likely to be most beneficial for treating this patient's neuropathic pain?
a. Opioid analgesic (morphine)
b. NSAID (ibuprofen)
c. Antiepileptic drug (gabapentin)
d. Narcotic analgesic with acetaminophen (hydrocodone)
C
Gabapentin is an antiepileptic (also known as an anticonvulsant) that is also used in adults to treat neuropathic pain. Opioids (e.g., morphine, hydrocodone) are most effective for certain types of pain. For instance, visceral pain, which is more generalized, is most responsive to opioid treatment, whereas neuropathic pain is resistant to opioids. Acetaminophen alone is likely not strong enough to relieve neuropathic pain.
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