Medication Summary
Major drugs of use are fluids for resuscitation, oxygen for respiratory support, tetanus prophylaxis, and analgesia. Follow standard therapeutic protocols for thermal burn injury. Antibiotic therapy, including topical agents (eg, silver sulfadiazine) and intravenous or oral agents, may be needed. Therapy for UV keratitis includes ophthalmological antibiotics and oral or intravenous pain medication. [10]
Gases
Class Summary
Oxygen is used to support respiration and metabolism.
Oxygen
Used to support respiration and metabolism.
Electrolytes
Class Summary
These agents are used to maintain hydration and salt balance.
Lactated Ringer with normal saline
Usually crystalloids such as normal saline or Ringer lactate; little indication for colloid use in acute burn management.
Topical burn treatment
Class Summary
This agent provides topical burn-healing and antimicrobial properties.
Silver sulfadiazine (Silvadene)
Contains both a sulfa antibiotic and a silver ion, which is an antibacterial; speeds burn healing and eases debridement.
Topical antibiotics
Class Summary
This agent is antibacterial and aids in burn healing.
Bacitracin topical (Baciguent)
Mild topical antibiotic, usually in an ointment base, for use on facial burns not deep enough to require grafting.
Immunizing agents
Class Summary
These agents are used to immunize patients against tetanus.
Tetanus toxoid adsorbed or fluid
Used to induce active immunity.
Immunizing agents of choice for most adults and children >7 y are tetanus and diphtheria toxoids. 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 the mid thigh laterally.
Tetanus immune globulin (TIG)
Used for passive immunization of any person with a wound that may be contaminated with tetanus spores.
Analgesic nonsteroidal anti-inflammatory drug
Class Summary
These agents are used to decrease inflammation and for basic pain control.
Ibuprofen (Advil, Excedrin IB, Ibuprin, Motrin)
Usually the DOC for mild to moderate pain, if no contraindications exist; inhibits inflammatory reactions and pain, probably by decreasing cyclooxygenase activity, which results in the inhibition of prostaglandin synthesis.
Naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
Used for relief of mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing activity of enzyme cyclooxygenase, which results in prostaglandin synthesis.
Analgesic, narcotic
Class Summary
This agent is used for severe pain from burns or UV keratitis.
Acetaminophen and codeine (Tylenol #2, Tylenol #3, Tylenol #4)
Combines analgesic effects of a centrally acting opium-derived alkaloid (codeine) and a peripherally acting nonopioid analgesic (acetaminophen). Indicated for treatment of mild to moderate pain.
Antibiotic, Ophthalmic
Erythromycin ophthalmic (E-Mycin)
Inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest.
Indicated for infections caused by susceptible strains of microorganisms and for prevention of corneal and conjunctival infections.
Moxifloxacin ophthalmic (Vigamox)
Indicated to treat bacterial conjunctivitis. Elicits antimicrobial effects. Inhibits topoisomerase II (DNA gyrase) and IV enzymes. DNA gyrase is essential in bacterial DNA replication, transcription, and repair. Topoisomerase IV plays a key role in chromosomal DNA portioning during bacterial cell division.
