Thromboangiitis Obliterans (Buerger Disease) Medication

Updated: Aug 07, 2018
  • Author: Naiem Nassiri, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to treat pain and reduce morbidity. Oral nonsteroidal anti-inflammatory drugs (NSAIDs) and narcotic analgesics can be administered to palliate ischemic pain.

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Nonsteroidal Anti-Inflammatory Drugs

Class Summary

NSAIDs have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase (COX) 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.

Naproxen (Naprosyn, Aleve, Naprelan, Anaprox)

Naproxen is used for the relief of mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing COX activity, which results in decreased prostaglandin synthesis.

Ibuprofen (Motrin, Advil, Addaprin, Caldolor)

Ibuprofen is the drug of choice (DOC) for patients with mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Indomethacin (Indocin)

Indomethacin is used for relief of mild to moderate pain; it inhibits inflammatory reactions and pain by decreasing the activity of COX, which results in a decrease of prostaglandin synthesis.

Diclofenac (Voltaren XR, Cataflam, Zipsor, Cambia, Zipsor, Zorvolex)

Diclofenac inhibits prostaglandin synthesis by decreasing COX activity, which, in turn, decreases formation of prostaglandin precursors.

Ketoprofen

Ketoprofen is used for relief of mild to moderate pain and inflammation. Small dosages are indicated initially in small patients, elderly patients, and patients with renal or liver disease. Doses higher than 75 mg do not increase the therapeutic effects. Administer high doses with caution, and closely observe the patient's response.

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Analgesics

Class Summary

Pain control is essential to quality patient care. It ensures patient comfort, promotes pulmonary toilet, and aids physical therapy regimens. Many analgesics have sedating properties that benefit patients who have sustained trauma.

Acetaminophen (Tylenol, FeverAll, Aspirin Free Anacin)

Acetaminophen is the DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, who have upper GI disease, or who are taking oral anticoagulants.

Acetaminophen and codeine (Tylenol #2, Tylenol #3, Tylenol #4)

This combination is indicated for the treatment of mild to moderate pain. The available dosage strengths are as follows:

•Tylenol #2: 300 mg Tylenol/15 mg codeine

•Tylenol #3: 300 mg Tylenol/30 mg codeine

•Tylenol #4: 300 mg Tylenol/60 mg codeine

Hydrocodone and acetaminophen (Vicodin, Lorcet, Lortab, Norco)

This drug combination indicated for moderate to severe pain.

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