Medication Summary
Opioid analgesics and nonsteroidal anti-inflammatory agents are the DOCs for pain associated with fractures.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Class Summary
Most commonly used for relief of mild to moderate pain. Effects of NSAIDs in the treatment of pain tend to be patient specific, yet ibuprofen usually is the DOC for initial therapy. Other options include flurbiprofen, ketoprofen, and naproxen.
Ibuprofen (Ibuprin, Advil, Motrin)
Usually DOC for treatment of mild to moderate pain, if no contraindications exist; inhibits inflammatory reactions and pain, probably by decreasing cyclooxygenase activity, which results in prostaglandin synthesis.
Naproxen (Anaprox, Naprelan, Naprosyn)
Used for relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing cyclooxygenase activity, which decreases prostaglandin synthesis.
Ketoprofen (Oruvail, Orudis, Actron)
Used for relief of mild to moderate pain and inflammation.
Administer small dosages initially to smaller patients, older persons, and 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.
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 treatment of pain in patients with documented hypersensitivity to aspirin or NSAIDs and in those with upper GI disease or those taking oral anticoagulants.
Acetaminophen and codeine (Tylenol #3)
Drug combination indicated for 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 relief of moderate to severe pain; DOC for aspirin-sensitive patients.
Oxycodone and aspirin (Percodan)
Drug combination indicated for relief of moderate to severe pain.
Morphine Sulfate (Duramorph, Astramorph, MS Contin)
DOC for narcotic analgesia due to its reliable and predictable effects, safety, and ease of reversibility with naloxone; IV doses vary and commonly are titrated until desired effect is obtained.
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