A 71-year-old man with a 15-year history of type 2 diabetes presents with burning pain and tingling in his feet bilaterally, worse at night. Examinati...

Question

A 71-year-old man with a 15-year history of type 2 diabetes presents with burning pain and tingling in his feet bilaterally, worse at night. Examination shows reduced pin-prick and temperature sensation in a stocking distribution. Vibration sense is reduced at the toes. Ankle reflexes are absent. Monofilament testing is abnormal. What is the MOST appropriate first-line pharmacological treatment for his neuropathic pain?

Accepted Answer

Amitriptyline 10 mg at night, or Duloxetine 60 mg daily, or Gabapentin 300 mg (titrated)

Answer

Paracetamol 1 g QDS

Answer

Ibuprofen 400 mg TDS

Answer

Oxycodone 5 mg BD

Answer

Topical Capsaicin only

uk-dgm MCQ (SBA): Neuropathic Pain - First-Line Treatment