Medication Summary
The goals of pharmacotherapy are to reduce morbidity and to prevent complications.
Analgesics
Class Summary
Generally, the usual pain medications (eg, aspirin with codeine, acetaminophen with codeine) may be used to relieve pain. Many patients with rhabdomyomas are asymptomatic; these patients rarely require strong pain medication.
Aspirin (Aspercin, Bufferin, Ecotrin, Durlaza)
Aspirin is a short-acting anti-inflammatory agent with rapid absorption in the proximal gastrointestinal (GI) tract. It inhibits inflammatory reactions and pain, probably by decreasing the activity of the enzyme cyclooxygenase and thereby inhibiting prostaglandin synthesis. It provides adequate pain relief. However, aspirin should be discontinued several days before any surgical treatment is undertaken to prevent excessive bleeding.
Codeine/acetaminophen (Tylenol #3)
Acetaminophen is the drug of choice for the treatment of pain in patients with documented hypersensitivity to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), as well as in those who have upper GI disease or who are taking oral anticoagulants. Codeine alters perception and response to pain by inhibiting ascending pain pathways. Indicated for the treatment of mild-to-moderate pain. Acetaminophen can be used safely before surgery.
Acetaminophen (Tylenol, Feverall, Acephen, Q-Pap)
Acetaminophen is the drug of choice for pain in patients who have documented hypersensitivity to aspirin or NSAIDs, who have upper GI disease, or who are taking oral anticoagulants. It may inhibit synthesis of prostaglandins in the central nervous system (CNS), and this may in turn work peripherally to block pain impulse generation.
Oxycodone and acetaminophen (Percocet, Endocet, Primlev, Xartemis XR)
This drug combination is indicated for the relief of moderate-to-severe pain. Oxycodone binds to opioid receptors within neuronal membranes of synapses, and this binding blocks pain perception in the cerebral cortex. Acetaminophen inhibits synthesis of prostaglandins in the CNS, and this in turn blocks peripheral generation of pain impulses.
Codeine
Codeine binds to opioid receptors in the CNS. It alters perception and response to pain by inhibiting ascending pain pathways. Codeine is used for the treatment of mild-to-moderate pain. It may be used in combination with acetaminophen, aspirin, or NSAIDs.
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Histopathology of adult rhabdomyoma. Microscopically, the adult rhabdomyoma contains deeply eosinophilic polygonal cells with peripherally placed nuclei. Cross-striations can be observed (X250).
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Atrial rhabdomyoma as seen on cardiac CT scan in a patient with tuberous sclerosis.
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Nonobstructive ventricular rhabdomyomas in a patient with tuberous sclerosis.
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Contrast-enhanced cardiac-gated T1-weighted MRI shows an enhancing left ventricular mass. At autopsy, this mass was found to be a cardiac rhabdomyoma.
