Within the complex medical rehabilitation of patients with apoplexia physiotherapy occupies an important position. The individual functional kinesitherapy on neurophysiological basis shall begin immediately after the acute pathological process. The electrotherapy may be used in the laxly as well as spastically paralysed muscle. In the early phase by this means the gradually developing spasticity and the muscle atrophies are diminished. The cryotherapy reduces the tonus of the spastic muscles and provides better prerequisites for the kinesitherapy. The work therapy has the task to restore the fine motoricity of the diseased hand and to make the patient again independent in the activities of daily life.
Pain caused by disorders of movement is often chronic and severe and may not be alleviated by commercially available medications. In such cases, the use of a compounded formulation can provide relief, either as sole therapy or as part of a combination treatment regimen. In this report, we review the effects of compounded analgesic preparations on chronic severe pain like that produced by arthritis, neuropathy, or postpolio syndrome. Case reports are included, formulations are presented, and two patients (one of whom, RFM III, is a coauthor of this paper) with a painful movement disorder describe their response to custom compounded therapy.
The ancient autoimmune skin condition psoriasis is still ubiquitous worldwide, produces the same, often-intolerable effects noted in its earliest recorded descriptions, and remains without cure. Management options designed to resolve the itchy, scaly, weeping, erythematous, and often widespread lesions of that disorder are now available, but they vary in efficacy, most are associated with the development of severe adverse effects, and many are prohibitively expensive. In this article, we describe the successful use of a compounded formulation of oral low-dose naltrexone to manage guttate psoriasis in a 75-year-old white male patient. That therapy produced only 1 adverse effect (dry skin near the lesions on the patient's arms and legs) and was relatively inexpensive. The formulation for that preparation and comments from the patient, the pharmacist who suggested its use, the prescriber, and the compounder who prepared it are included. Many clinicians are unaware of the benefits of compounded low-dose naltrexone in treating autoimmune diseases. We hope that this case report will encourage compounding pharmacists to consider and suggest it as an alternative therapy for patients who cannot tolerate or afford manufactured medications to treat psoriasis.
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Lower back pain in cats, especially that caused by intervertebral disk disease, inhibits movement, greatly compromises quality of life, and, without treatment can persist unabated long term. The basic diagnostic workup available to many feline patients with low back discomfort can yield inconclusive results, and in confirmed cases of intervertebral disk disease, decompression surgery can be relatively expensive for the client and not without risk to the patient. Thus empirical treatment with an effective analgesic that is safe for and well tolerated by cats with low back pain is a welcome and reasonable option for many pet owners. In this case report, the use of a compounded suspension of gabapentin in an older cat with suspected lumbosacral intervertebral disk disease is described. That preparation was prescribed because commercially available tablets of gabapentin cannot be split to yield an accurate dose for this feline patient and manufactured gabapentin solution, which is not available as a generic but only as the branded product Neurontin, contains xylitol, which can be toxic to cats.
