Tetanus Medication

  • Author: Patrick B Hinfey, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Sep 28, 2011
 

Medication Summary

The goals of pharmacotherapy are to prevent complications and to reduce morbidity.

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Antimicrobials

Class Summary

Therapy must cover all likely pathogens in the context of the clinical setting.

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Metronidazole (Flagyl)

 

A study comparing oral metronidazole to intramuscular penicillin showed better survival, shorter hospitalization, and less progression of disease in the metronidazole group (dosed at 0.5 g q6h or 1 g q12h IV for 7-10 d).

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Penicillin G (Pfizerpen)

 

Interferes with synthesis of cell wall mucopeptide during active multiplication, resulting in bactericidal activity against susceptible microorganisms.

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Doxycycline (Vibramycin)

 

Inhibits protein synthesis and thus bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria.

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Benzodiazepines

Class Summary

These agents may act in the central nervous system to induce muscle relaxation.

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Diazepam (Valium, Diastat, Diazepam Intensol)

 

Modulates postsynaptic effects of GABA-A transmission, resulting in an increase in presynaptic inhibition. Appears to act on part of the limbic system, the thalamus, and hypothalamus, to induce a calming effect. Also has been found to be an effective adjunct for the relief of skeletal muscle spasm caused by upper motor neuron disorders.

Rapidly distributes to other body fat stores. Twenty minutes after initial IV infusion, serum concentration drops to 20% of Cmax.

Individualize dosage and increase cautiously to avoid adverse effects.

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Contributor Information and Disclosures
Author

Patrick B Hinfey, MD  Research Director and Associate Residency Director, Department of Emergency Medicine, Newark Beth Israel Medical Center; Clinical Assistant Professor of Emergency Medicine, New York College of Osteopathic Medicine

Patrick B Hinfey, MD, is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Stroke Association, Emergency Medicine Residents Association, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

Jill Ripper, MD, MS  Residency Director, Newark Beth Israel Medical Center

Jill Ripper, MD, MS is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Christian August Engell, MD  Attending Physician, Department of Infectious Diseases, Newark Beth Israel Medical Center

Christian August Engell, MD is a member of the following medical societies: Infectious Diseases Society of America and Infectious Diseases Society of New Jersey

Disclosure: Nothing to disclose.

Keith N Chappell, MD  Administrative Chief Resident, Junior Attending Resident, Department of Emergency Medicine, Newark Beth Israel Medical Center

Disclosure: Newark Beth Israel Medical Center Salary Employment

Specialty Editor Board

Gregory William Rutecki  MD, Professor of Medicine, University of South Alabama Medical School

Gregory William Rutecki is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society of Nephrology, National Kidney Foundation, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Richard B Brown, MD, FACP  Chief, Division of Infectious Diseases, Baystate Medical Center; Professor, Department of Internal Medicine, Tufts University School of Medicine

Richard B Brown, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and Massachusetts Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Eleftherios Mylonakis, MD, to the development and writing of this article.

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