Medication Summary
Generally, analgesics and anxiolytics are the drugs that are used to treat fractures. In addition, administer proper antibiotics in cases of open fractures.
Analgesics
Class Summary
Pain control is essential to quality patient care because it ensures patient comfort, promotes pulmonary toilet, and enables physical therapy regimens. Most analgesics have sedating properties, which are beneficial for patients who have sustained traumatic injuries.
Fentanyl (Duragesic, Sublimaze)
Short duration (30-60 min) makes titration easy. Excellent choice for pain management and sedation. Easily and quickly reversed by naloxone.
Morphine sulfate (Duramorph, Astramorph, MS Contin)
DOC for narcotic analgesia because of its reliable and predictable effects, safety profile, and ease of reversibility with naloxone. The IV form may be dosed in a number of ways and is commonly titrated until the desired effect is obtained.
Propoxyphene/acetaminophen (Darvocet N-100)
Drug combination indicated for mild to moderate pain.
Hydrocodone bitartrate and acetaminophen (Vicodin ES)
Indicated for moderate to severe pain.
Codeine/acetaminophen (Tylenol With Codeine)
Indicated for mild to moderate pain.
Anxiolytics
Class Summary
Patients with painful injuries usually experience significant anxiety. Anxiolytics allow the clinician to administer a smaller analgesic dose to achieve the same effect as a higher dose would.
Lorazepam (Ativan)
A sedative hypnotic in the benzodiazepine class. Has a short onset of effect and a relatively long half-life. May depress all levels of the CNS, including limbic and reticular formation, by increasing the action of GABA, which is a major inhibitory neurotransmitter in the brain.
Midazolam (Versed)
DOC for acute anxiety and sedation to aid in reduction of fractures or dislocations. Provides antegrade amnesia with dose within 1-2 h.
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Total volar displacement of distal radius fracture from patient fall; mechanism consistent with Smith fracture. Posteroanterior (PA) view of left wrist shows complex comminuted fracture deformity of the distal radius with overlap of the fracture fragments and antipalmar angulation of the fracture apex.
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Total volar displacement of distal radius fracture from patient fall; mechanism consistent with Smith fracture. Anteroposterior (AP) external rotation view of left wrist shows complex comminuted fracture deformity of the distal radius with overlap of the fracture fragments and antipalmar angulation of the fracture apex.
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Total volar displacement of distal radius fracture from patient fall; mechanism consistent with Smith fracture. Lateral view of left wrist shows ulnar sided subluxation of the ulna in relation to the distal carpal bones.
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Reduction obtained by volar inversion of hand on forearm and axial traction. Posteroanterior (PA) view of left wrist post-reduction shows interval reduction of the comminuted fracture of the distal radius with probably extension of fracture lines to the articular surface.
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Reduction obtained by volar inversion of hand on forearm and axial traction. Lateral view of left wrist post-reduction shows interval reduction of the ulnar subluxation.
