American Board of Internal Medicine (ABIM) Certification Practice Exam

Which medication can be used for the treatment of post-herpetic neuralgia along with topical lidocaine?

1. Gabapentin

2. Ibuprofen

3. Oxycodone

4. Amitriptyline

The correct answer is: Gabapentin

Gabapentin is a medication that is commonly used for the treatment of post-herpetic neuralgia in addition to topical lidocaine. This condition arises as a complication of herpes zoster (shingles) and is characterized by persistent pain in the area of the skin that was affected by the rash after the rash has healed. Gabapentin is an anticonvulsant that works by modulating the release of excitatory neurotransmitters and reducing neuronal excitability. It is particularly effective for neuropathic pain conditions, including post-herpetic neuralgia. Patients often experience reduced pain perception and improved quality of life with the addition of gabapentin to their treatment regimen. Other medications, such as ibuprofen, while useful for general pain relief, do not specifically target the neuropathic aspect of post-herpetic neuralgia. Oxycodone, an opioid analgesic, can provide pain relief but also carries risks of dependence and side effects that may not make it an ideal first-line treatment for this type of pain. Amitriptyline, a tricyclic antidepressant, is indeed another option for neuropathic pain, but the question specifically asked for a medication that, alongside topical lidocaine, is commonly used and recognized in clinical