External Medicine
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Itch (Pruritus)
CAUSES
Lipman ZM, Yosipovitch G. Substance use disorders and chronic itch. J Am Acad Dermatol. 2021. PMID: 32891774.
MY SUMMARY: reviews the theoretic pathophysiologic dopaminergic and opioid mechanisms for itch and parallels to mechanisms for substance abuse. Highlights CNS stimulants and opioids that could contribute to itch. Mainly:
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Opioids: morphine, heroin, oxycodone, oxycontin, codeine, buprenorphine
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CNS stimulants: cocaine, amphetamine, dextroamphetamine (Adderall), lisdexamfetamine (Vyvanse), MDMA (ecstasy, E, Molly)
TREATMENT
Ketamine
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Infusion of ketamine 100mg (along with lidocaine 100mg), and a nerve block of bupivacaine was effective at providing sustained itch relief for brachioradial pruritus after 2 infusions. 37531125