Pediatric Limp Medication

Updated: Sep 20, 2019
  • Author: Brian Wai Lin, MD; Chief Editor: Kirsten A Bechtel, MD  more...
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Medication

Medication Summary

Pediatric patients with limping usually can be treated with nonnarcotic analgesic or nonsteroidal anti-inflammatory medications. Some require glucocorticoids, muscle relaxants, or antibiotics. Opiate analgesia rarely is needed.

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Analgesics

Class Summary

Pain control is essential to quality patient care and ensures patient comfort.

Ibuprofen (Motrin, Advil)

NSAID DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Acetaminophen (Tylenol)

DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, with upper GI disease, or who are taking oral anticoagulants. Inhibits cyclooxygenase in the CNS.

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Benzodiazepines

Class Summary

These agents may act in the spinal cord to induce muscle relaxation.

Diazepam (Valium)

Depresses all levels of CNS (eg, limbic and reticular formation), possibly by increasing activity of GABA.

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Glucocorticoids

Class Summary

These agents are used as anti-inflammatories for inflamed muscle and soft tissues.

Prednisone (Deltasone, Orasone, Sterapred)

May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity.

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Antibiotics

Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.

Ceftriaxone (Rocephin)

Third-generation cephalosporin with broad-spectrum, gram-negative activity; lower efficacy against gram-positive organisms; higher efficacy against resistant organisms. Arrests bacterial growth by binding to one or more penicillin-binding proteins.

Its long half-life allows for once-daily dosing.

Cefuroxime (Ceftin)

Second-generation cephalosporin maintains gram-positive activity that first-generation cephalosporins have; adds activity against Proteus mirabilis, Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, and Moraxella catarrhalis.

Condition of patient, severity of infection, and susceptibility of microorganism determines proper dose and route of administration.

Nafcillin (Nafcil, Unipen)

Initial therapy for suspected penicillin G-resistant streptococcal or staphylococcal infections.

Use parenteral therapy initially in severe infections. Change to oral therapy as condition warrants.

Because of thrombophlebitis, particularly in children and elderly persons, administer parenterally only for short term (1-2 d); change to oral route as clinically indicated.

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