Help for the Pain: The Pharmacist s Role in Treating Fibromyalgia
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1 Help for the Pain: The Pharmacist s Role in Treating Fibromyalgia Russ Carter, MD, MBA This program has been financially supported by an educational grant from Pfizer.
2 Help for the Pain: The Pharmacist s Role in Treating Fibromyalgia Speaker: Russell Carter, MD practices at the Pain Management Center at Allegheny General Hospital in Pittsburgh, Pennsylvania where he performs interventional procedures, chronic pain management and inpatient consults. He is a member of the American Pain Society, International Spine Intervention Society, and the American Society of Interventional Pain Physicians. He has unrestricted state medical licenses in Texas, Pennsylvania and Florida. Dr. Carter is a medical degree graduate of St. George s School of Medicine and a Pre-medicine, Masters of Business Administration, and Bachelors of Business Administration graduate of the University of Texas at Austin. He is currently completing the Feldenkrais professional training program. His interests include shiatsu, massage, craniosacral therapy and golfing. Speaker Disclosure: Dr. Carter has no actual or potential conflicts of interest in relation to this program This program has been financially supported by an educational grant from Pfizer. PharmCon is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education Legal Disclaimer: The material presented here does not necessarily reflect the views of Pharmaceutical Education Consultants (PharmCon) or the companies that support educational programming. A qualified healthcare professional should always be consulted before using any therapeutic product discussed. Participants should verify all information and data before treating patients or employing any therapies described in this educational activity.
3 Help for the Pain: The Pharmacist s Role in Treating Fibromyalgia Accreditation: L01-P L01-T Target Audience: Pharmacists & Technicians CE Credits: 1.0 Continuing Education Hour or 0.1 CEU for pharmacists/technicians Expiration Date: 09/18/2012 Program Overview: Pharmacists can play a key role in alleviating the shortcomings and misunderstanding about fibromyalgia. They can provide valuable counseling on topics such as lifestyle modifications and treatment options for fibromyalgia. Simple changes can often lead to considerable symptom improvement. Once fibromyalgia has been diagnosed, the pharmacist can provide counseling about managing comorbidities, drug contraindications, and general safety issues. Objectives: Review the clinical features and spectrum of associated conditions for fibromyalgia to include the American College of Rheumatology general classification guidelines established for diagnosis. Outline the current FDA approved pharmaceutical therapies used in fibromyalgia to include their mechanisms of action, efficacy, dosing, safety, and tolerability profiles. Review the role of complementary and alternative medicine (CAM) in fibromyalgia treatment. Describe active role pharmacists can play in counseling patients on management strategies to include life style changes and complementary/alternative therapies to assist patients cope with the debilitating pain of fibromyalgia. This program has been financially supported by an educational grant from Pfizer.
4 FibroMyOucha or FIBRomYALgIA
5 The OMG sort of gets lost, but people who deal with Fibro patients develop a lower case omg
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7 Fibromyalgia Topics 3 different patient populations Defining fibromyalgia Symptoms and coexisting diagnosis Important resources in management Business opportunities for pharmacies
8 Those who rarely see a physician for Fibro (Diagnose and Adios) Those who see their Primary Care Physician And a few specialists, to rule-out, no scripts Those who the PCPs turf to Pain Management These are people who want to be fixed and be 20 again
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12 Other Symptoms Anxiety, fatigue, poor sleep, morning stiffness, stomach headaches, photosensitivity, dizziness, paresthesias, poor memory
13 Other Conditions May Coexist (Rule em out) Rheumatoid arthritis, lupus and other rheumatologic Multiple sclerosis and other neurologic disorders Infectious diseases like Mono, Lyme Disease, Rocky Mountain Spotted Fever Sleep disorders Allergies
14 Additional Conditions (Rule em out) Chronic fatigue syndrome Depression/Anxiety/PTSD Endometriosis Irritable bowel syndrome (IBS) DJD/Osteoarthritis Restless legs syndrome
15 A question for you. What is the most important resource? Type your answer into the chat box!
16 Commonly used Medications Neuromodulators Anti-depressants Pain medications Best to avoid Vicodin/hydrocodone Percocet/oxycodone Xanax/alprazolam Ativan/lorazepam
17 Vicodin/hydrocodon e Percocet/oxycodone The patient should switch to Opana ER/oxymorphone or MSContin/natural morphine
18 Benzo s Xanax/alprazolam Ativan/lorazepam Change to Valium/diazepam Then to Buspar/buspirone
19 Neuromodulators Lyrica/pregabalin Cymbalta/duloxetine Savella/milnacipran
20 DENIAL While this medication has an FDA indication for fibromyalgia, the compendia of medical literature supports the use of other medications such as TCAs.
21 Psychologist Absolutely, any normal person who has been in pain for a long time should be depressed A Psychologist can be very helpful Find one who knows fibro
22 Don t go it alone! Don t try to re-invent the wheel! Essential! The American Chronic Pain Association
23 A Friend It is good to have one, but it is better to be one! Share with friends Limit the time spent on the topic Fibro can be tough on others If one asks, answer honestly and briefly
24 Family Family support is important Let others care for, Not take care of
25 Modalities? TENS Heat/Ice Massage/Acupuncture
26 Theracane
27 Exercise Start Slowly Increase Slowly Every Day Every Day Every Day
28 SLEEP IS VERY IMPORTANT Avoid Sleep Medication Use Sleep Hygiene
29 Very Important There may be foods that are not tolerated and the patient won t even know it!
30 AVOID Aspartame (NutraSweet) MSG and nitrates Sugar, fructose, simple carbohydrates Caffeine (coffee, tea, colas, chocolate) Yeast and gluten Dairy Nightshades (tomatoes, chili and bell peppers, potatoes, eggplant)
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32 SUPPLEMENTS
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34 YOU The patient has to learn to help others help them (Locus of Control) Make sure the patient keeps an organized copy of all meds and tests
35 It Takes All of These Ingredients to Add Up to:
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Additional information >>> HERE <<< How To Getting Natural Cure To Fibromyalgia Scam or Work?
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