Medication Summary
Analgesics may provide pain relief (acetaminophen for moderate pain, tramadol HCl for severe pain). NSAIDs may alleviate the pain, as well as reduce the inflammatory component. Narcotic medication is not indicated for this condition.
Analgesics
Class Summary
Pain control is essential to quality patient care. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who have sustained trauma or who have sustained injuries.
Acetaminophen (Tylenol, Panadol, Aspirin Free Anacin)
Provides pain relief. May be a first-line drug therapy, especially in those with contraindications to NSAID use. May use on a prn basis.
Tramadol HCl (Ultram)
Inhibits ascending pain pathways, altering the perception of and response to pain. Also inhibits reuptake of norepinephrine and serotonin.
Indicated for moderate to moderately severe pain. This drug is generally not a first-line DOC, but it is a reasonable second-line DOC in those who do not have opioid dependency.
Nonsteroidal Anti-inflammatory Drug (nsaid), Cox-2 Selective
Class Summary
COX-2 selective drugs are:
Indicated for the relief of the signs and symptoms of osteoarthritis, rheumatoid arthritis in adults, and ankylosing spondylitis
Indicated for the management of acute pain in adults
Indicated for the treatment of primary dysmenorrhea
Indicated to reduce the number of adenomatous colorectal polyps in familial adenomatous polyposis
Celecoxib (Celebrex)
A 4-[5-(4-methylphenyl)-3-(triflouromethyl)-1H-pyrazol-1-yl) benzenesulfonamide and a diaryl-substituted pyrazole. Primarily inhibits COX-2. COX-2 is considered an inducible isoenzyme, induced by pain and inflammatory stimuli. Inhibition of COX-1 may contribute to NSAID GI toxicity. At therapeutic concentrations, COX-1 isoenzyme is not inhibited, thus incidence of GI toxicity, such as endoscopic peptic ulcers, bleeding ulcers, perforations, and obstructions, may be decreased when compared to nonselective NSAIDs. Seek lowest dose for each patient.
Nonsteroidal Anti-inflammatory Drug (NSAID), Oral
Class Summary
NSAIDs have analgesic, anti-inflammatory, and antipyretic activities. The mechanism of action of these agents is not known, but they may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation and various cell membrane functions. Many NSAIDs are currently on the market. In general, the mechanism of action of these agents is the same. No evidence exists that one NSAID is more efficacious than another; however, individual response may differ.
Flurbiprofen (Ansaid)
May inhibit the cyclooxygenase enzyme, which in turn inhibits prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.
Ibuprofen (Ibuprin, Advil, Motrin)
First-line DOC for the reduction of pain and inflammation. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
Ketoprofen (Actron, Orudis, Oruvail)
For relief of mild to moderate pain and inflammation.
Small dosages are initially indicated in small and elderly patients and in those with renal or liver disease. Doses over 75 mg do not increase therapeutic effects. Administer high doses with caution and closely observe patient response.
Naproxen (Naprelan, Naprosyn, Anaprox)
For the relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing the activity of cyclooxygenase, which results in a decrease of prostaglandin synthesis.
Dietary Supplements
Class Summary
Dietary supplements may provide nutrients that may play a role in the formation of cartilage.
Glucosamine sulfate
Dietary supplement derived from crab shells. Hypothesized to provide the structural building blocks that are used in regenerating articular cartilage.
Chondroitin sulfate
Dietary supplement derived from bovine trachea. Hypothesized to provide the structural building blocks that are used to regenerate articular cartilage.
