Medication Summary

The goals of pharmacotherapy are to reduce patient morbidity and prevent complications.

Class Summary

NSAIDs are anti-inflammatory and non-narcotic medications that have analgesic and antipyretic activities. The mechanism of action of these agents is not known, but NSAIDs 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. The treatment of pain tends to be patient specific.

Ibuprofen (Ibuprin, Advil, Motrin)

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DOC for mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Class Summary

Local anesthetics block the generation of conduction impulses in a nerve, thereby preventing the transmission of pain.

Bupivacaine (Sensorcaine, Marcaine)

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An amide-type local anesthetic that shares similar properties with other drugs in this classification, including lidocaine (Xylocaine; AstraZeneca, Mississauga, Ontario, Canada). Has the advantage of a longer duration of anesthesia.

Administer the smallest dose and concentration that is required to produce the desired results. Dose varies with the anesthetic procedure, the area to be anesthetized, the vascularity of the tissues, and individual tolerance.

Class Summary

Glucocorticoids stimulate synthesis of enzymes that decrease inflammatory responses and suppress the immune system.

Methylprednisolone (Depo-Medrol)

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Methylprednisolone is a potent, intermediate-acting glucocorticoid, which has no mineralocorticoid activity. A useful anti-inflammatory and immunosuppressant agent.

Follow-up

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Media Gallery

Biceps muscle and tendons.

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Author

Britt A Durham, MD Director of Risk Management, Department of Emergency Medicine, Martin Luther King Medical and Trauma Center, King-Drew Medical Center; Assistant Professor of Emergency Medicine, Drew College of Medicine; Assistant Clinical Professor of Emergency Medicine, UCLA School of Medicine; Partner and Chief Financial Officer, Durcress Medical Group, California Medical Board District Medical Consultant, Lakewood Atheletic Sports Medicine Team Physician

Britt A Durham, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Richard Chambers, MD Chief of Orthopedic, Diabetes and Amputee Service, Clinical Associate Professor, Department of Orthopedic Surgery, Rancho Los Amigos Medical Center, University of Southern California

Richard Chambers, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Diabetes Association, American Orthopaedic Foot and Ankle Society, Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Sherwin SW Ho, MD Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, Herodicus Society, American Orthopaedic Society for Sports Medicine

Disclosure: Received consulting fee from Biomet, Inc. for speaking and teaching; Received grant/research funds from Smith and Nephew for fellowship funding; Received grant/research funds from DJ Ortho for course funding; Received grant/research funds from Athletico Physical Therapy for course, research funding; Received royalty from Biomet, Inc. for consulting.

Additional Contributors

David T Bernhardt, MD Director of Adolescent and Sports Medicine Fellowship, Associate Professor, Department of Pediatrics/Ortho and Rehab, Division of Sports Medicine, University of Wisconsin School of Medicine and Public Health

David T Bernhardt, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Sections Bicipital Tendonitis
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Bicipital Tendonitis Medication

Medication Summary

Nonsteroidal anti-inflammatory drugs (NSAIDs)