EXTERNAL ANALGESICSBy: Vaughn Benton

LEARNING OBJECTIVES

UPON COMPLETION OF THIS PRESENTATION, THE STUDENT WILL BE ABLE TO:

1. Define the term “external analgesic”

2. List the various topical drugs available as nonprescription external analgesic products (generic and brand names)

3. Discuss the differences in mechanisms of action between the various external analgesic products identified

4. Identify specific factors to discuss when providing patient education

SO... WHAT ARE EXTERNAL ANALGESICS? An external analgesic is a medication for pain management designed to be applied externally, rather than being taken internally.

For the treatment and management of musculoskeletal injuries and disorders, many patients commonly use nonprescription topical analgesics.

Available in several different formulations, including gels, ointments, creams, lotions, sprays, and patches,

These products may have local analgesic, anesthetic, antipruritic and/or counterirritant effects.

Identification Please...

WHY SO SERIOUS?

IDENTIFICATION

1. Methyl Salicylate2. Trolamine Salicylate 3. Menthol4. Camphor5. Capsaicin

METHYL SALICYLATE Origin

Oil of Wintergreen

Effect When AppliedRubefacient

produces redness of the skin e.g. by causing dilation of the capillaries and an increase in blood circulation.

TROLAMINE SALICYLATE Origin

Salt formed between triethanolamine and salicylic acid

Effect When AppliedRubefacient

Produces redness of the skin e.g. by causing dilation of the capillaries and an increase in blood circulation.

MENTHOL Origin

Peppermint and Other Mint Oils

Effect When AppliedCooling

CAMPHOR Origin

Wood of camphor laurel, a large evergreen in Asia

Effect When Applied

CAPSAICIN Origin

Chili Peppers

Effect When AppliedBurning

PRODUCTS YOU’RE FAMILIAR WITH...

Flex-power was founded in 2001 for athletes who disliked the smell of existing sports-related pain relief products.

They received guidance from PowerBar founder, Brian Maxwell and hired scientists who developed the Flexpower formula within a year.

The company indicates that liposome nanotechnology is used in Flex-power to embed the active ingredients in tiny particles for delivery through the skin.

TIGER KNOWS BEST

CLINICAL TEACHING1. Pharmacists should advise patients that

nonprescription topical analgesics are intended to treat mild to moderate pain for no longer than 7 days.

2. Factors that may be considered when selecting a nonprescription topical analgesic include dosage form, cost, ease of use, odor, and the patient’s medical history, including possible allergies.

3. Patients who are taking anticoagulation therapy should be cautioned not to use topical products that contain salicylates

CLINICAL TEACHING4. Patients should be counseled on the proper use

of these products, which include using them as directed and only applying topical products to intact skin.

5. Hands should always be washed after applying topical products and before touching the eyes or mucous membranes.

6. Patients should be advised to consult their primary health care provider if pain changes in severity or persists after 7 days of self-treatment.

MISCONCEPTIONS & PRECAUTIONS

1. “Its perfectly alright to take a spoonful of Vick’s VapoRub by mouth.”

2. Pad and Patch Don’t Match!

3. Location, location, location

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