Lightning Injuries Medication

  • Author: Mary Ann Cooper, MD; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: Feb 10, 2012
 

Medication Summary

In an individual who has been struck by lightning, the use of NSAIDs for the first few days may decrease long-term neurologic damage. Although no studies have examined this, NSAIDs are the only medications available for lightning injuries at this time. The use of long-term ibuprofen, vitamin C (1 g/day), and vitamin E (400 U/day) have been shown to decrease long-term injury and scarring with electrical injury. Whether these free-radical scavengers have any effect on lightning injuries is unknown, but since they are administered in routine doses, there is probably little harm in their use.

One report has addressed the use of high-dose steroids administered for optic neuritis caused by lightning based on the presumed efficacy originally reported for spinal cord injury treatment with high-dose steroids. No controlled studies have been performed to show whether there is any efficacy.

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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Class Summary

These are used as prophylaxis to prevent long-term neurologic damage and to treat chronic pain syndromes that may develop from sympathetic nervous system injuries caused by lightning.

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Ibuprofen (Motrin, Advil, Ibu, Neoprofen)

 

Ibuprofen inhibits inflammatory reactions and pain, probably by decreasing the activity of the enzyme cyclo-oxygenase, which results in prostaglandin synthesis.

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Naproxen (Anaprox, Aleve, Naprosyn, Naprelan)

 

Naproxen is used for the relief of mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing the activity of the enzyme cyclo-oxygenase, which results in prostaglandin synthesis.

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Sulindac (Clinoril)

 

Sulindac decreases COX activity and, in turn, inhibits prostaglandin synthesis. This results in decreased formation of inflammatory mediators.

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Meloxicam (Mobic)

 

Meloxicam decreases COX activity, and this, in turn, inhibits prostaglandin synthesis. These effects decrease the formation of inflammatory mediators.

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Ketoprofen

 

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 greater than 75 mg do not increase the therapeutic effects. Administer high doses with caution, and closely observe the patient's response.

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Flurbiprofen

 

Flurbiprofen may inhibit COX, thereby, in turn, inhibiting prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.

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Contributor Information and Disclosures
Author

Mary Ann Cooper, MD  Professor Emerita, Department of Emergency Medicine, University of Illinois at Chicago

Mary Ann Cooper, MD, is a member of the following medical societies: American Academy of Emergency Medicine, American Meteorological Association, and National Lightning Safety Institute

Disclosure: vaisala None None

Coauthor(s)

Richard F Edlich, MD, PhD, FACS, FASPS, FACEP  Distinguished Professor Emeritus of Plastic Surgery, Biomedical Engineering and Emergency Medicine, University of Virginia Health Care System

Richard F Edlich, MD, PhD, FACS, FASPS, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Association of Plastic Surgeons, American Burn Association, American College of Emergency Physicians, American College of Surgeons, American Society of Plastic and Reconstructive Surgery, American Spinal Injury Association, American Surgical Association, American Trauma Society, Plastic Surgery Research Council, Society of University Surgeons, and Surgical Infection Society

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD  Attending Physician, Department of Emergency Medicine, Cambridge Health Alliance, Division of Emergency Medicine, Harvard Medical School

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

Additional Contributors

Marc D Basson, MD, PhD, MBA Professor, Chair, Department of Surgery, Michigan State University

Marc D Basson, MD, PhD, MBA is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Gastroenterological Association, Phi Beta Kappa, and Sigma Xi

Disclosure: Nothing to disclose.

H Scott Bjerke, MD, FACS Clinical Associate Professor, Department of Surgery, University of Missouri-Kansas City School of Medicine; Medical Director of Trauma Services, Research Medical Center; Clinical Associate Professor, Department of Surgery, Indiana University School of Medicine

H Scott Bjerke, MD, FACS is a member of the following medical societies: American Association for the History of Medicine, American Association for the Surgery of Trauma, American College of Surgeons, Association for Academic Surgery, Eastern Association for the Surgery of Trauma, Midwest Surgical Association, National Association of EMS Physicians, Pan-Pacific Surgical Association, Royal Society of Medicine, Southwestern Surgical Congress, andWilderness Medical Society

Disclosure: Nothing to disclose.

David B Drake, MD, FACS Associate Professor, Department of Plastic Surgery, Medical Director, DeCamp Burn and Wound Center, Program Director, Hand Fellowship, University of Virginia School of Medicine

David B Drake, MD, FACS is a member of the following medical societies: American Association for Hand Surgery, American Burn Association, American College of Surgeons, American Society for Reconstructive Microsurgery, American Society of Plastic and Reconstructive Surgery, Association for Surgical Education, Southeastern Society of Plastic and Reconstructive Surgeons, and Southern Medical Association

Disclosure: Nothing to disclose.

John Geibel, MD, DSc, MA Vice Chairman, Professor, Department of Surgery, Section of Gastrointestinal Medicine and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital

John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract

Disclosure: AMGEN Royalty Other

Edmond A Hooker II, MD, DrPH, FAAEM Assistant Professor, Department of Emergency Medicine, University of Cincinnati College of Medicine

Edmond A Hooker II, MD, DrPH, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Public Health Association, Society for Academic Emergency Medicine, and Southern Medical Association

Disclosure: Nothing to disclose.

William B Long III, MD, FACS, FASTS President, Trauma Specialists, LLP; Legacy Emanuel Trauma Center, Legacy Emanuel Hospital, Portland, Oregon

William B Long III, MD, FACS, FASTS is a member of the following medical societies: American Association for the Surgery of Trauma, American College of Chest Physicians, American College of Surgeons, American Thoracic Society, American Trauma Society, and Society of Thoracic Surgeons

Disclosure: Nothing to disclose.

Dennis P Orgill, MD, PhD Professor of Surgery, Harvard Medical School; Associate Chief of Plastic Surgery, Brigham and Women's Hospital

Dennis P Orgill, MD, PhD is a member of the following medical societies: American Medical Association, American Society for Reconstructive Microsurgery, Massachusetts Medical Society, and Plastic Surgery Research Council

Disclosure: Kinetic Concepts, Inc. Grant/research funds Principle Investigator; Brigham and Women's Hospital Royalty None; Kinetic Concepts, Inc. Expert Witness None

Robert L Sheridan, MD Assistant Chief of Staff, Chief of Burn Surgery, Shriners Burns Hospital; Associate Professor of Surgery, Department of Surgery, Division of Trauma and Burns, Massachusetts General Hospital and Harvard Medical School

Robert L Sheridan, MD is a member of the following medical societies: American Academy of Pediatrics, American Association for the Surgery of Trauma, American Burn Association, and American College of Surgeons

Disclosure: Nothing to disclose.

Wayne Karl Stadelmann, MD Stadelmann Plastic Surgery, PC

Wayne Karl Stadelmann, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Society of Plastic Surgeons, New Hampshire Medical Society, Northeastern Society of Plastic Surgeons, and Phi Beta Kappa

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 Reference Salary Employment

Lars M Vistnes, MD, FRCSC, FACS Professor of Surgery, Emeritus, Stanford University Medical Center

Lars M Vistnes, MD, FRCSC, FACS is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

James Steven Walker, DO, MS Clinical Professor of Surgery, Department of Surgery, University of Oklahoma Health Sciences Center

James Steven Walker, DO, MS is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, and American Osteopathic Association

Disclosure: Nothing to disclose.

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