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Carpal Bone Injuries Medication

  • Author: Bryan C Hoynak, MD, FACEP, FAAEM; Chief Editor: Sherwin SW Ho, MD  more...
 
Updated: Jan 11, 2016
 

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.

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Analgesics

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.

Fentanyl (Duragesic, Sublimaze)

 

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

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.

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Anxiolytics

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.

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.

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 Surgeons, American Heart Association, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Russell D White, MD Clinical Professor of Medicine, Clinical Professor of Orthopedic Surgery, 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, American Medical Society for Sports Medicine

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 Division of the Biological Sciences, The Pritzker School of Medicine

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

Disclosure: Received consulting fee from Biomet, Inc. for speaking and teaching; Received grant/research funds from Smith and Nephew for fellowship funding; Received grant/research funds from DJ Ortho for course funding; Received grant/research funds from Athletico Physical Therapy for course, research funding; Received royalty from Biomet, Inc. for consulting.

Additional Contributors

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

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, Sierra Sacramento Valley Medical Society

Disclosure: Nothing to disclose.

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