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Rehabilitation for Anterior Cruciate Ligament Injury Medication

  • Author: Tarek O Souryal, MD; Chief Editor: Consuelo T Lorenzo, MD  more...
 
Updated: Mar 01, 2016
 

Medication Summary

The goal of pharmacotherapy is to reduce morbidity.

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Nonsteroidal anti-inflammatory drugs

Class Summary

These agents have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell-membrane functions.

Ibuprofen (Motrin, Ibuprin)

 

DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

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Narcotics

Class Summary

Pain control is essential to quality patient care. If nonsteroidal anti-inflammatory drugs (NSAIDs) are not sufficient, then narcotics may be given. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial to patients who have sustained trauma or injuries.

Acetaminophen and codeine (Tylenol #3)

 

Indicated for the treatment of mild to moderate pain.

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COX-2 inhibitors

Class Summary

These drugs can be used as an alternative if the patient has GI upset or a history of GI bleeding with NSAID use. Because of the cost, these medications are not always a first-line choice.

Celecoxib (Celebrex)

 

Inhibits primarily COX-2. COX-2 is considered an inducible isoenzyme, being induced during pain and inflammatory stimuli. Inhibition of COX-1 may contribute to NSAID GI toxicity. At therapeutic concentrations, COX-1 isoenzyme is not inhibited; thus, GI toxicity may be decreased. Seek the lowest dose of celecoxib for each patient.

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Contributor Information and Disclosures
Author

Tarek O Souryal, MD Head Team Physician, Dallas Mavericks; Director, Texas Sports Medicine and Orthopaedic Group; Staff, Department of Orthopaedic Surgery, Presbyterian Hospital of Dallas; Clinical Professor, Departments of Orthopedic Surgery and Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center

Tarek O Souryal, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

Michael T Andary, MD, MS Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, Association of Academic Physiatrists

Disclosure: Received honoraria from Allergan for speaking and teaching.

Chief Editor

Consuelo T Lorenzo, MD Medical Director, Senior Products, Central North Region, Humana, Inc

Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Additional Contributors

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM President and Director, Georgia Pain Physicians, PC; Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Emory University School of Medicine

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Medical Association, International Association for the Study of Pain, Texas Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Kenneth Adams, MD Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical School

Kenneth Adams, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

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