Medication Summary
Implement medical therapy as indicated by the patient's medical condition. Administer tetanus prophylaxis if indicated.
Toxoid
Class Summary
Toxoid is used for immunization; a booster injection in previously immunized individuals is recommended.
Tetanus toxoid adsorbed or fluid
Used to induce active immunity against tetanus in selected patients. The 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.
Opioid Analgesics
Class Summary
These agents ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who have sustained injuries.
Morphine sulfate (Duramorph, Astramorph, MS Contin, MSIR, Oramorph)
Appropriate for analgesia due to reliable and predictable effects, safety profile, and ease of reversibility with naloxone.
Various intravenous doses are used; commonly titrated until desired effect obtained.
Opioid Analgesics
Fentanyl (Sublimaze)
Analgesic useful for patients with hypotension or volume depletion due to minimal effects on blood pressure
Antibacterials, Topical
Bacitracin topical (Baciguent)
Topical bacitracin is used for burns in cosmetically sensitive areas (eg, face) due to less dyspigmentation following use than with silver sulfadiazine.
Topical antibiotics
Class Summary
Therapy must be comprehensive and cover all likely pathogens in the context of this clinical setting.
Silver sulfadiazine (Silvadene, Thermazene, SSD, SSD-AF)
Useful in prevention of infections from second-degree or third-degree burns. Has bactericidal activity against many gram-positive and gram-negative bacteria, as well as yeast.
Nonsteroidal anti-inflammatory agents (NSAIDs)
Class Summary
These agents have analgesic, antiinflammatory, and antipyretic activities. Mechanism of action is not known but may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell-membrane functions, may exist as well.
Ibuprofen (Motrin, Ibuprin)
Drug of choice for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
Naproxen (Aleve, Naprelan, Naprosyn, Anaprox)
For relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing activity of cyclooxygenase, which results in a decrease of prostaglandin synthesis.
