Postherpetic neuralgia in an elderly patient.

A 67-year-old patient presented to the community pharmacy with poorly controlled postherpetic neuralgia (PHN) pain following an episode of herpes zoster. The clinical pharmacist did a medication review and found that, although the patient was receiving medications proven effective in the treatment of PHN, she was not receiving optimal therapy. Additionally, the patient was experiencing intolerable side effects. The pharmacist provided recommendations to the patient's primary care physician that ultimately improved the patient's pain control. Managing PHN pain requires practitioners to be vigilant in titrating pain regimens and trying various combinations of therapies with different mechanisms of action. Such an approach is one that tailors medication therapy to each individual patient, provides the most relief, and restores a patient's quality of life.