1. Pharmacotherapy in Myofascial Pain Dysfunction Syndrome (MPDS)
Dr.F Anbari
05-Feb-17

2. Dr.F Anbari
05-Feb-17

3. Pain control
1-Pharmacologic 2-Physical therapy 3-Behavioral therapy & relaxation technique
Dr.F Anbari
05-Feb-17

4. Drugs Mild Analgesics Nonsteroidal anti-inflammatory drugs(NSAIDs)
Antianxiety agents
Tricyclic antidepressant
Muscle relaxant
NSAIDs are probably the most commonly prescribed medication for pain control in TMD therapy
Dr.F Anbari
05-Feb-17

5. short-term or intermittent use of drugs are preferred but a smaller percentage of patients who evolve into a chronic musculoskeletal pain disorder are usually taking combinations of medications long term.
Opioids are usually reserved for complex chronic pain disorders or briefly for acute injuries to the TMJs or muscles where moderate to severe pain is present.
Dr.F Anbari
05-Feb-17

6. Naproxen 500 mg twice daily in a six-week trial was more effective than ibuprofen or celecoxib.
NSAIDs for most TMDs should be used short term to supplement the other nondrug therapies that should reduce the need for long-term NSAID therapy.
A mild analgesic such as acetaminophen might be a first choice for analgesic drug treatment .
A combination of ibuprofen and acetaminophen is commonly regarded as more effective than either medication alone for certain pains.
Dr.F Anbari
05-Feb-17

7. The long-acting benzodiazepine clonazepam is effective ,but more recently, 10 mg cyclobenzaprine, a muscle relaxant, taken at bedtime was found to be superior to clonazepam at managing jaw pain on awakening.
Dr.F Anbari
05-Feb-17

8. Muscle relaxants are a class of drugs that act in the CNS, inhibiting interneurons and depressing motor activity. These medications are used before sleep because of their sedative effects. Some patients taking 10 mg of cyclobenzaprine at bedtime experience continued sedation into the day, but they are able to tolerate a lower dose by splitting the tablet into two or four sections and taking one section. The sedative effects of cyclobenzaprine may contribute to their efficacy and, in addition, be of value in promoting sleep, which is often also compromised in individuals with pain.
Dr.F Anbari
05-Feb-17

9. Tricyclic antidepressants, particularly amitriptyline, have proven to be effective in managing chronic orofacial pain. Amitriptyline is analgesic at low doses, has sedative effects, and promotes restful sleep. It is the anticholinergic effects of the drug (dry mouth, weight gain, sedation, and dysphoria) that often make it intolerable. An effective dose can be as low as 10 mg at night but can be increased gradually to 75–100 mg, depending on the patient’s tolerance of the side effects
Dr.F Anbari
05-Feb-17

10. Depression commonly accompanies chronic pain; referral for depression-relevant dosages of antidepressant medications should be considered.
Dr.F Anbari
05-Feb-17

11. Dr.F Anbari
05-Feb-17