Der Schmerz
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Case Reports
[DRESS syndrome : Rare and potentially lethal allergic reaction to carbamazepine-a case report].
A 64-year-old man with chronic low back pain had been treated with tramadol, meloxicam and metamizole for several years. Due to additional neuropathic pain in the lower extremities, the medication was complemented with carbamazepine. After 5 weeks of treatment, the patient developed maculopapulose exanthema and fever, followed by hepatitis, leukocytosis and eosinophilia. ⋯ The previously diagnosed neuropathic pain syndrome cannot be verified. After appropriate modification of therapy, the patient's pain perception was significantly reduced, allowing for complete withdrawal of pain-relieving medication. This case report illustrates that merely pharmacological treatment of chronic pain syndromes bears only little prospect of success but increased risk of side effects.
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Small molecules can have a significant effect on human metabolic processes. Computational drug design aims at constructing specialized small molecules that selectively and efficiently address specific proteins. ⋯ Modern computational drug design goes far beyond the lock and key principle. Possible future developments are discussed and a current successful example of computational drug design in the field of painkiller medication is demonstrated.