Medication Summary
The goals of pharmacotherapy are to reduce morbidity and to prevent complications and infections.
Antibiotics
Class Summary
Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.
Amoxicillin and clavulanate (Augmentin)
Drug combination that treats bacteria resistant to beta-lactam antibiotics.
Penicillin VK (Pfizerpen)
Inhibits the biosynthesis of cell wall mucopeptide. Bactericidal against sensitive organisms when adequate concentrations are reached and most effective during the stage of active multiplication. Inadequate concentrations may produce only bacteriostatic effects.
Clindamycin (Cleocin)
Lincosamide for treatment of serious skin and soft-tissue staphylococcal infections. Also effective against aerobic and anaerobic streptococci (except enterococci). Inhibits bacterial growth, possibly by blocking the dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest. DOC in penicillin-allergic patients.
Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS, Septra, Septra DS)
Inhibits bacterial growth by inhibiting synthesis of dihydrofolic acid. Antibacterial activity of TMP-SMZ includes common urinary tract pathogens, except Pseudomonas aeruginosa.
Decongestants
Class Summary
Decongestants reduce mucosal edema.
Phenylephrine nasal (Neo-Synephrine)
Applied directly to nasal mucous membranes where it stimulates alpha-adrenergic receptors and causes vasoconstriction. Decongestion occurs without drastic changes in blood pressure, vascular redistribution, or cardiac stimulation.
Analgesics
Class Summary
Pain control is essential to quality patient care. Analgesics ensure patient comfort and promote pulmonary toilet.
Acetaminophen (Tylenol, Feverall, 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. Effective in relieving mild to moderate acute pain; however, it has no peripheral anti-inflammatory effects. May be preferred in elderly patients because of fewer GI and renal side effects.
Hydrocodone/acetaminophen
Drug combination indicated for moderate to severe pain.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Class Summary
NSAIDs have analgesic and antipyretic activities. The mechanism of action of these agents is not known, but NSAIDs 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. Treatment of pain tends to be patient specific.
Ibuprofen (Advil, Excedrin IB, Ibuprin, Motrin)
DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
Anesthetics
Class Summary
Anesthetic agents are used to produce local anesthesia.
Cocaine
Decreases membrane permeability to sodium ions, which, in turn, inhibits depolarization and blocks conduction of nerve impulses.
Use the lowest dose necessary to produce anesthesia. The 4% solution is available as a 4-mL unit-dose vial (total of 16 mg of cocaine) or 10-mL multidose vial (total of 40 mg cocaine).
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