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Fingertip Injuries Medication

  • Author: Glen Vaughn, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
 
Updated: Sep 23, 2015
 

Medication Summary

The goal of pharmacotherapy is to reduce pain. Tetanus immunization also may be indicated.

A study of the use of prophylactic antibiotics after fingertip amputation concluded that routine prophylactic use of antibiotics does not reduce the rate of infection after fingertip amputations. In the study, 29 patients were randomly assigned to the no-antibiotic group and 27 to the antibiotic group, but at follow-up, there was no infection in either group.[14]

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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.

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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.

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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.

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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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Contributor Information and Disclosures
Author

Glen Vaughn, MD Director, Department of Emergency Medicine, Defiance Hospital

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.

Eric L Legome, MD Chief, Department of Emergency Medicine, Kings County Hospital Center; Professor Clinical, Department of Emergency Medicine, State University of New York Downstate College of Medicine

Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, Council of Emergency Medicine Residency Directors, American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Jeffrey Glenn Bowman, MD, MS Consulting Staff, Highfield MRI

Disclosure: Nothing to disclose.

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Significant nailbed injuries can occur from nail root avulsions.
Removal of the nail plate with iris scissors.
Suturing of a nailbed laceration.
Sutured nailbed injury.
U-stitch method of securing the nail plate.
 
 
 
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