Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Medicine
Volume 2015, Article ID 392874, 5 pages
http://dx.doi.org/10.1155/2015/392874
Case Report

Topical and Intranasal Analgesic Therapy in a Woman with Refractory Postherpetic Neuralgia

1Department of Clinical Pharmacy, University of Tennessee Health Science Campus, 193 Polk Avenue, Suite 2D, Nashville, TN 37210, USA
2University of Tennessee Health Science Campus, 193 Polk Avenue, Suite 2D, Nashville, TN 37210, USA

Received 5 March 2015; Accepted 25 March 2015

Academic Editor: Albert Dahan

Copyright © 2015 Kenneth C. Hohmeier and Lyndsey M. Almon. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A patient-specific, stepped approach to topical and intranasal analgesic pharmacotherapy was effective in reducing refractory postherpetic neuralgia (PHN) not responding to the current standard of care for PHN. The use of topical analgesic therapy allowed for higher concentrations of medication locally while reducing the likelihood of systemic side effects common to the drugs used. No adverse effects were noted for either topical or intranasal drug therapy. The patient-specific, stepped approach resulted in clinically significant decreases in pain on visual analog scale (VAS), with the use of intranasal ketamine 10% solution and topical gabapentin 6%, ketoprofen 10%, lidocaine 5%, and ketamine 10% cream.