Elbow and Forearm Overuse Injuries Medication
- Author: Vincent N Disabella, DO, FAOASM; Chief Editor: Sherwin SW Ho, MD more...
Medical intervention is aimed toward the joint goals of decreasing inflammation and providing analgesia. The major concern is the effect on the gastrointestinal (GI) tract with the long-term use of certain medications. Renal function must be followed with long-term NSAID use. Long-term corticosteroid use has a myriad of side effects, which are beyond the scope of this article.
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Nonsteroidal anti-inflammatory drugs
NSAIDs are used to help reduce inflammation and are used as analgesics. Numerous drugs comprise this class, and physicians should be aware of each NSAID subclass, as some patients respond better to one subclass than another subclass. A few of the medications are named below, not to belabor the wide variety of choices available.
Cyclooxygenase-2 (COX-2) inhibitors are new-generation NSAIDs that are supposed to have decreased GI side effects. Although the GI side-effect profiles of these drugs may be slightly better than the previous generation of NSAIDs, their efficacy is not any more impressive. These drugs inhibit COX-2, but they do not inhibit COX-1.
Has good anti-inflammatory properties and exceptional analgesic properties. Used as a first-line medication because of the qd dosing, which helps with patient compliance.
Available in 100-mg and 150-mg doses for patients who do not tolerate the higher dose. All doses should be taken with food.
Available in many dosages and delivery systems. Fairly inexpensive and has a similar therapeutic profile to the other NSAIDs.
Corticosteroids are some of the strongest anti-inflammatory agents available. Injectable preparations make it possible to deliver the drug directly to the joint in a concentrated dose, while greatly decreasing systemic effects.
Oral prednisone is used in cases when inflammation is severe and the patient has contraindications to the administration of steroidal injections. Use with great caution because of systemic effects.
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