gabapentinoid; GABA analog
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Contraindications
- perioperative gabapentinoids of minimal benefit for postoperative pain[3]
Adverse effects
- respiratory depression in patients with COPD
- perioperative gabapentinoids for hip replacement or knee replacement associated with excess pulmonary complications & do not spare opioid use[2]
- prescription of gabapentinoids leads to a prescribing cascade resulting in unnecessary use of diuretics[4][5]
- gabapentinoid use is associated with an increased risk of hip fractures, especially in frail elderly or with chronic kidney disease[6]
Drug interactions
- increased risk of respiratory depression in combination with opiates
- drug interaction(s) anticonvulsants with anti-bacterial agents
- drug interaction(s) anticonvulsants with statins
Mechanism of action
- structurally related to GABA, but does not interact with GABA receptors
- binds to alpha-2 delta subunit of voltage-gated Ca+2 channel
- membrane stabilizer
- may affect hypothalamic thermoregulatory centers
More general terms
More specific terms
References
- ↑ FDA Drug Safety Communication. Dec 19, 2019 FDA warns about serious breathing problems with seizure and nerve pain medicines gabapentin (Neurontin, Gralise, Horizant) and pregabalin (Lyrica, Lyrica CR). When used with CNS depressants or in patients with lung problems https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-serious-breathing-problems-seizure-and-nerve-pain-medicines-gabapentin-neurontin
FDA Drug Safety Watch. Dec 19, 2019 Neurontin, Gralise, Horizant (gabapentin) and Lyrica, Lyrica CR (pregabalin): Drug Safety Communication - Serious Breathing Problems. https://www.fda.gov/safety/medical-product-safety-information/neurontin-gralise-horizant-gabapentin-and-lyrica-lyrica-cr-pregabalin-drug-safety-communication - ↑ 2.0 2.1 Ohnuma T, Raghunathan K, Moore S et al. Dose-dependent association of gabapentinoids with pulmonary complications after total hip and knee arthroplasties. J Bone Joint Surg Am 2020 Feb 5; 102:221 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31804238
- ↑ 3.0 3.1 Verret M et al. Perioperative use of gabapentinoids for the management of postoperative acute pain: A systematic review and meta-analysis. Anesthesiology 2020 Aug; 133:265. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32667154 https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2766309
Kharasch ED et al. Perioperative gabapentinoids: Deflating the bubble. Anesthesiology 2020 Aug; 133:251. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32667153 https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2766307 - ↑ 4.0 4.1 Read SH, Giannakeas V, Pop P et al Evidence of a gabapentinoid and diuretic prescribing cascade among older adults with lower back pain. J Am Geriatr Soc 2021 Oct; 69:2842 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34118076 https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.17312
- ↑ 5.0 5.1 Growdon ME, Jing B, Morris EJ et al. Which older adults are at highest risk of prescribing cascades? A national study of the gabapentinoid-oop diuretic cascade. J Am Geriatr Soc 2024 Jun; 72:1728-1740 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38547357 https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.18892
- ↑ 6.0 6.1 George J Gabapentinoids Tied to Hip Fractures in Older Adults. Risk of hip fracture was high in people with frailty or chronic kidney disease. MedPage Today November 13, 2024 https://www.medpagetoday.com/neurology/painmanagement/112894
Leung MTY, Turner JP, Marquina C Gabapentinoids and Risk of Hip Fracture. JAMA Netw Open. 2024 Nov 4;7(11):e2444488. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39535796 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2826109