Sternal Fracture Medication

Updated: Jul 12, 2017
  • Author: Scott Felten, MD, FACEP; Chief Editor: Trevor John Mills, MD, MPH  more...
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Medication

Medication Summary

Primary treatment is adequate analgesia with nonsteroidal anti-inflammatory drugs and opiates. Select these on the basis of relative indications and contraindications for each patient and administer in standard doses and routes. Since sternal fractures can take weeks to heal, do not hesitate to offer adequate analgesia for this recovery period. No other pharmacologic therapies are indicated specifically for treatment of sternal fractures.

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Nonsteroidal anti-inflammatory agents (NSAIDs)

Class Summary

These agents are most commonly used for relief of mild to moderately severe pain. Effects of NSAIDs in the treatment of pain tend to be patient specific, yet ibuprofen is usually the drug of choice for initial therapy. Other options include fenoprofen, flurbiprofen, ketoprofen, and naproxen.

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.

Ketoprofen (Oruvail, Orudis, Actron)

Used for relief of mild to moderately severe pain and inflammation. Administer small dosages initially to patients with small bodies, older persons, and those with renal or liver disease. Doses higher than 75 mg do not increase therapeutic effects. Administer high doses with caution and closely observe for response.

Naproxen (Anaprox, Naprelan, Naprosyn)

Used for relief of mild to moderately severe pain. Inhibits inflammatory reactions and pain by decreasing activity of enzyme cyclooxygenase, which inhibits prostaglandin synthesis.

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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 fractures.

Acetaminophen (Tylenol, Panadol, aspirin-free Anacin)

DOC for treatment of pain in patients with documented hypersensitivity to aspirin or NSAIDs or those with upper GI disease or taking oral anticoagulants.

Acetaminophen and codeine (Tylenol #3)

Drug combination indicated for treatment of mild to moderately severe pain.

Hydrocodone bitartrate and acetaminophen (Vicodin ES)

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

Oxycodone and acetaminophen (Percocet)

Drug combination indicated for relief of moderately severe to severe pain. DOC for aspirin-hypersensitive patients.

Morphine sulfate (Duramorph, Astramorph, MS Contin)

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

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Acetylsalicylic acids

Class Summary

These agents are effective in reducing pain and inflammation.

Aspirin (Anacin, Ascriptin, Bayer aspirin)

Used for treatment of mild to moderately severe pain and headache. Blocks prostaglandin synthetase action, which inhibits prostaglandin synthesis and prevents formation of platelet-aggregating thromboxane A2. Also acts on hypothalamus heat-regulating center to reduce fever.

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