Carpal Bone Injuries Medication

Author: Bryan C Hoynak, MD, FACEP, FAAEM; Chief Editor: Sherwin SW Ho, MD more...

Updated: Feb 28, 2010

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Medication Summary
Analgesics
Anxiolytics
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Medication Summary

Generally, analgesics and anxiolytics are the drugs that are used to treat fractures. In addition, administer proper antibiotics in cases of open fractures.

Class Summary

Pain control is essential to quality patient care because it ensures patient comfort, promotes pulmonary toilet, and enables physical therapy regimens. Most analgesics have sedating properties, which are beneficial for patients who have sustained traumatic injuries.

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Fentanyl (Duragesic, Sublimaze)

Short duration (30-60 min) makes titration easy. Excellent choice for pain management and sedation. Easily and quickly reversed by naloxone.

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Morphine sulfate (Duramorph, Astramorph, MS Contin)

DOC for narcotic analgesia because of its reliable and predictable effects, safety profile, and ease of reversibility with naloxone. The IV form may be dosed in a number of ways and is commonly titrated until the desired effect is obtained.

Propoxyphene/acetaminophen (Darvocet N-100)

Drug combination indicated for mild to moderate pain.

Hydrocodone bitartrate and acetaminophen (Vicodin ES)

Indicated for moderate to severe pain.

Codeine/acetaminophen (Tylenol With Codeine)

Indicated for mild to moderate pain.

Class Summary

Patients with painful injuries usually experience significant anxiety. Anxiolytics allow the clinician to administer a smaller analgesic dose to achieve the same effect as a higher dose would.

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Lorazepam (Ativan)

A sedative hypnotic in the benzodiazepine class. Has a short onset of effect and a relatively long half-life. May depress all levels of the CNS, including limbic and reticular formation, by increasing the action of GABA, which is a major inhibitory neurotransmitter in the brain.

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Midazolam (Versed)

DOC for acute anxiety and sedation to aid in reduction of fractures or dislocations. Provides antegrade amnesia with dose within 1-2 h.

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Contributor Information and Disclosures

Author

Bryan C Hoynak, MD, FACEP, FAAEM Associate Clinical Professor of Emergency Medicine, University of California at Irvine School of Medicine; Director of Emergency Services, Chairman of Division of Emergency Medicine, Placentia-Linda Hospital

Bryan C Hoynak, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Burn Association, American College of Emergency Physicians, American College of Surgeons, and American Heart Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Janos P Ertl, MD Assistant Professor, Department of Orthopedic Surgery, Indiana University School of Medicine; Chief of Orthopedic Surgery, Wishard Hospital

Janos P Ertl, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Hungarian Medical Association of America, and Sierra Sacramento Valley Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Russell D White, MD Professor of Medicine, Director of Sports Medicine Fellowship Program, Medical Director, Sports Medicine Center, Head Team Physician, University of Missouri-Kansas City Intercollegiate Athletic Program, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center Lakewood

Russell D White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American Association of Clinical Endocrinologists, American College of Sports Medicine, American Diabetes Association, and American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Jon B Whitehurst, MD Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital

Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Breg, Inc. Consulting fee Consulting; Biomet, Inc. Consulting fee Consulting; GMV, Inc. Arthroscopy Simulator Evaluation and teaching; Smith and Nephew Grant/research funds Fellowship funding; DJ Ortho Grant/research funds Course funding

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