Shoulder Dislocation Medication
- Author: L. Edward Seade, MD; Chief Editor: Craig C Young, MD more...
Medication Summary
Shoulder dislocations are extremely painful events. If relocation is not accomplished within an hour, anesthesia via conscious sedation is necessary in the emergency department setting. Medications for this technique are not discussed in this article.
Oral narcotic analgesics are reasonable for a period of days, but prolonged use is categorically inappropriate.
Analgesics
Class Summary
Pain control is essential to quality patient care. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who have sustained trauma. A 3- or 4-day supply of hydrocodone or similar schedule III narcotic should be provided following shoulder relocation.
Hydrocodone and acetaminophen (Lortab, Norcet, Vicodin)
Drug combination for moderate to severe pain.
Hydrocodone and ibuprofen (Vicoprofen)
Drug combination for short-term (< 10 d) relief of moderate to severe acute pain.
Codeine/acetaminophen (Tylenol With Codeine)
Indicated for mild to moderate pain.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Class Summary
NSAIDs have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms may also exist, such as leukotriene synthesis inhibition, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions. During rehabilitation, shoulder discomfort may interfere with sleep or basic ADLs. Oral NSAIDs should decrease the discomfort. NSAIDs do not speed recovery and should not be used to accelerate physical therapy goals.
Ibuprofen (Motrin, Ibuprin)
DOC for mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
Naproxen (Naprosyn, Anaprox, Naprelan, Aleve)
For mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing the activity of cyclooxygenase, which results in a decrease of prostaglandin synthesis.
Ketoprofen (Orudis, Oruvail, Actron)
For mild to moderate pain and inflammation. Small initial doses are indicated in small and elderly patients and in those with renal or liver disease.
Doses >75 mg do not increase the therapeutic effects. Administer high doses with caution and closely observe the patient for response.
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