Medication Summary
The goal of pharmacotherapy is to reduce pain. Tetanus immunization also may be indicated.
Nonsteroidal anti-inflammatory agents (NSAIDs)
Class Summary
Commonly used for relief of mild to moderate pain. Effects of NSAIDs in treating pain tend to be patient specific, yet ibuprofen is usually the DOC for initial therapy. Other options include flurbiprofen, naproxen, and ketoprofen.
Ibuprofen (Ibuprin, Advil, Motrin)
DOC for treatment of mild to moderate pain, if no contraindications are present. Inhibits inflammatory reactions and pain probably by decreasing activity of the enzyme cyclooxygenase, which inhibits prostaglandin synthesis.
Ketoprofen (Oruvail, Orudis, Actron)
Used for relief of mild to moderate pain and inflammation. Small dosages initially are indicated in small and elderly patients and in those with renal or liver disease. Doses >75 mg do not increase its therapeutic effects. Administer high doses with caution and closely observe patient for response.
Naproxen (Anaprox, Naprelan, Naprosyn)
Used for relief of mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing activity of enzyme cyclooxygenase, which decreases prostaglandin synthesis.
Flurbiprofen (Ansaid)
Has analgesic, antipyretic, and anti-inflammatory effects. May inhibit cyclooxygenase enzyme, inhibiting prostaglandin biosynthesis that may result in analgesic and anti-inflammatory activities.
Analgesics
Class Summary
Pain control is essential to quality patient care. It ensures patient comfort, promotes pulmonary toilet, and aids physical therapy regimens. Many analgesics have sedating properties that benefit patients who have sustained fractures.
Acetaminophen (Tylenol, Panadol, Aspirin-free Anacin)
DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, with upper GI disease, or who are taking oral anticoagulants.
Acetaminophen and codeine (Tylenol #3)
Drug combination indicated for the treatment of mild to moderate pain.
Hydrocodone bitartrate and acetaminophen (Vicodin ES)
Drug combination indicated for the relief of moderate to severe pain.
Oxycodone and acetaminophen (Percocet)
Drug combination indicated for the relief of moderate to severe pain. DOC for aspirin-hypersensitive patients.
Toxoid
Class Summary
Used for tetanus immunization. Administer booster injection in previously immunized individuals to prevent this potentially lethal syndrome.
Tetanus toxoid adsorbed or fluid
Used to induce active immunity against tetanus in selected patients. The immunizing agent of choice for most adults and children aged >7 years are tetanus and diphtheria toxoids. Necessary to administer booster doses to maintain tetanus immunity throughout life. Pregnant patients should receive only tetanus toxoid, not a diphtheria antigen-containing product. May administer into deltoid or midlateral thigh muscles in children and adults. In infants, preferred site of administration is the mid thigh laterally.
Immunoglobulins
Class Summary
Patients who may not have been immunized against Clostridium tetani products should receive tetanus immune globulin (Hyper-Tet).
Tetanus immune globulin (TIG)
Used for the passive immunization of persons with wounds that may be contaminated with tetanus spores.
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