Foot Fracture Medication

Updated: Aug 03, 2017
  • Author: Robert Silbergleit, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Medication

Medication Summary

Analgesics (narcotics, NSAIDs) are generally the only medications needed to treat foot fractures. Administer antibiotics and tetanus prophylaxis to patients with open fractures.

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Nonsteroidal Anti-inflammatory Agents (NSAIDS)

Class Summary

These agents are used most commonly for relief of mild to moderately severe pain. Effects of NSAIDs in treatment of pain tend to be patient specific, yet ibuprofen is usually DOC for initial therapy. Other NSAIDS also may be used.

Ibuprofen (Ibuprin, Advil, Motrin)

Usually DOC for treatment of mild to moderately severe pain, if no contraindications. Inhibits inflammatory reactions and pain, probably by decreasing activity of enzyme cyclooxygenase, which inhibits prostaglandin synthesis.

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Narcotic Combination 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 fractures. Hydrocodone and oxycodone preparations are generally more effective and better tolerated than other narcotic-acetaminophen combinations such as those containing codeine.

Hydrocodone bitartrate and acetaminophen (Vicodin ES)

Drug combination indicated for relief of moderately severe to severe pain.

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Antibiotics

Class Summary

Prophylaxis is given to patients with open fractures.

Penicillin G (Pfizerpen)

Interferes with synthesis of cell wall mucopeptide during active replication, resulting in bactericidal activity against susceptible microorganisms.

Clindamycin (Cleocin)

Lincosamide is useful as treatment against serious skin and soft-tissue infections caused by most staphylococcal strains. Also effective against aerobic and anaerobic streptococci, except enterococci. Clindamycin is used for prophylaxis in penicillin-allergic patients. Useful as treatment against streptococci and most staphylococcal strains.

Gentamicin (Gentacidin, Garamycin)

Aminoglycoside antibiotic used for gram-negative bacterial coverage. Commonly used in combination with both an agent against gram-positive organisms and one that covers anaerobes. Used in conjunction with ampicillin or vancomycin for prophylaxis in patients with open fractures.

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Tetanus Toxoid

Class Summary

This agent is used for tetanus immunization. Booster injection is recommended in previously immunized individuals to prevent this potentially lethal syndrome.

Tetanus toxoid adsorbed or fluid

Induces active immunity against tetanus in selected patients. Tetanus and diphtheria toxoids are the immunizing DOC for most adults and children older than 7 y. Necessary to administer booster doses to maintain tetanus immunity throughout life. Pregnant patients should receive only tetanus toxoid, not a diphtheria antigen-containing product. In children and adults, may administer into deltoid or midlateral thigh muscles. In infants, preferred site of administration is midthigh laterally.

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