Drug Selection for Intrathecal Drug Delivery



The use of intrathecal agents to treat pain and other diseases such as spasticity is based on the principle that delivering drugs directly to the cerebral spinal fluid (CSF) bypasses the first-pass effect and results in a higher degree of effectiveness when compared with other routes of delivery such as the oral or transdermal approach. The result of this improvement in delivery is a favorable equipotent dosing comparison. It also results in less impact on the end organs and overall reduced systemic drug exposure.


Cerebral Spinal Fluid Opioid Therapy Inflammatory Mass Intrathecal Therapy Risk Avoidance 
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Suggested Reading

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    Deer T, Krames E, Hassenbusch S, et al. Polyanalgesic consensus conference 2007: recommendations for the management of pain by intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel. Neuromodulation. 2007;10(4):300–328.Google Scholar
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    Deer T, Caraway D, Kim C. Clinical experience with intrathecal bupivacaine in combination with opioid for the treatment of chronic pain related to failed back surgery syndrome and metastatic cancer pain of the spine. Spine J. 2002;2(4):274–278.PubMedCrossRefGoogle Scholar
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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Center for Pain ReliefCharlestonUSA

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