Posterior Long Arm Splinting Medication
- Author: Lisa Jacobson, MD; Chief Editor: Erik D Schraga, MD more...
The goals of pharmacotherapy are to reduce morbidity and prevent complications. Drugs used for injuries include various NSAIDs and analgesics. The strength of the analgesics depends on the type of pain resulting from the injury.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are the drugs of choice for the initial treatment of myofascial pain.
Ibuprofen inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis. It is used to provide relief of cervical myofascial pain.
Indomethacin is thought to be the most effective NSAID for the treatment of ankylosing spondylitis, although no scientific evidence supports this claim. It is used for relief of mild to moderate pain; it inhibits inflammatory reactions and pain by decreasing the activity of COX, which results in a decrease of prostaglandin synthesis.
Naproxen is used for relief of mild to moderate pain; it inhibits inflammatory reactions and pain by decreasing the activity of COX, which results in a decrease of prostaglandin synthesis.
Diclofenac inhibits prostaglandin synthesis by decreasing COX activity, which, in turn, decreases formation of prostaglandin precursors.
Ketoprofen is used for relief of mild to moderate pain and inflammation. Small dosages are indicated initially in small patients, elderly patients, and patients with renal or liver disease. Doses higher than 75 mg do not increase the therapeutic effects. Administer high doses with caution, and closely observe the patient's response.
These medications provide control of moderate to severe pain.
This drug combination is indicated for moderate to severe pain.
Acetaminophen with codeine (Tylenol-3)
This drug combination is indicated for mild to moderate pain.
This drug combination is indicated for the relief of moderately severe to severe pain. It is the agent of choice for aspirin-hypersensitive patients. Different strengths are available.
This drug combination is indicated for the relief of moderately severe to severe pain.
Antihistamines generally work well for pruritus. The first-generation H1 antagonists (eg, diphenhydramine, hydroxyzine, doxepin, chlorpheniramine, cyproheptadine) are inexpensive and effective in reducing pruritus, but drowsiness and anticholinergic effects can be troublesome. The second-generation antihistamines (loratadine, desloratadine, fexofenadine, cetirizine, and levocetirizine) have much lower sedative effects. Any patient who is taking a medication that has potential sedative effects should be cautioned about driving and operating heavy machinery.
Fexofenadine is a nonsedating second-generation antihistamine. It is tolerated very well, with a rate of sedation that is not significantly different from that of placebo.
Cetirizine selectively inhibits histamine H1 receptor sites in blood vessels, the gastrointestinal (GI) tract, and the respiratory tract, thereby inhibiting physiologic effects that histamine normally induces at H1 receptor sites. Once-daily dosing is convenient. Bedtime dosing may be useful if sedation is a problem.
Diphenhydramine is used for symptomatic relief of symptoms caused by release of histamine. It is the most commonly used first-generation antihistamine, available without a prescription in the United States.
Hydroxyzine hydrochloride antagonizes H1 receptors in the periphery. It may suppress histamine activity in the subcortical region of the central nervous system (CNS).
Loratadine selectively inhibits peripheral histamine H1 receptors. It is tolerated very well, with a rate of sedation that is not significantly different from that of placebo. The once-daily dosing makes it convenient.
Desloratadine is a long-acting tricyclic histamine antagonist that is selective for H1 receptors. It is a major metabolite of loratadine, which, after ingestion, is extensively metabolized to the active metabolite 3-hydroxydesloratadine.
Levocetirizine is an H1-receptor antagonist, an active enantiomer of cetirizine. It is a second-generation prescription antihistamine, available as a 5-mg breakable (scored) tab and a 0.5-mg/mL oral solution.
Chlorpheniramine is a first-generation agent that competes with histamine for H1-receptor sites on effector cells in blood vessels and the respiratory tract. It is one of the safest antihistamines to use during pregnancy.
Cyproheptadine is a first-generation agent used for symptomatic relief of allergic symptoms caused by histamine release. It prevents histamine release in blood vessels and is more effective in preventing histamine response than in reversing it. It may be useful in patients with syndromes sustained by histamine-producing tumors.
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