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OR50 Orthopedics
Common Medications
Toronto Notes 2019
Common Medications
Table 28. Common Medications
Drug Name
cefazolin (Ancef®)
heparin
LMWH
dalteparin (Fragmin®) enoxaparin (Lovenox®) fondaparinux (Arixtra®)
oral anticoagulants
dabigatran (Pradaxa®) rivaroxaban (Xarelto®) apixaban
tranexamic acid (TXA) midazolam (Versed®)
fentanyl (Sublimaze®)
propofol (Diprivan®)
ibuprofen (Advil®, Motrin®)
triamcinolone (Aristocort®) – an injectable steroid
naproxen (Aleve®, Naprosyn®)
misoprostol (Cytotec®) indomethacin (Indocid®)
Dosing Schedule
1-2 g IV q8h 5000 IU SC q12h
5000 IU SC OD 30-40 mg SC bid 2.5 mg SC OD
110 mg PO x1 then 220 mg PO OD
10 mg PO OD
2.5 mg PO bid
10-20 mg/kg IV
Topical application to wound
0.02-0.04 mg/kg IV 0.5-3 μg/kg IV
1-2 mg/kg IV Maintenance 0.5 mg/kg
200-400 mg tid
0.5-1 mL of 25 mg/mL
250-500 mg bid
200 μg qid 25 mg PO tid
Indications
Pre-operative antibiotic prophylaxis
DVT prophylaxis DVT prophylaxis
DVT prophylaxis
Reduce perioperative blood loss and transfusion
Conscious sedation for short procedures
IV anesthetic IV anesthetic
Analgesia for inflammatory pain arthritis)
Suspension (injected into inflamed joint or bursa); amount varies by joint size
Analgesia for pain due to inflammation, arthritis, soft tissue injury
Prophylaxis of HO after THA Prophylaxis of HO after THA
Comments
First generation cephalosporin; do not use with penicillin allergy
Monitor platelets, follow PTT which should rise 1.5-2x
Fixed dose, no monitoring, improved bioavailability, increased bleeding rates
Predictable, no monitoring, oral administration; no antidote
No evidence for increase in thromboembolic events
Medication used during fracture reduction – monitor for respiratory depression
Short acting anesthetic used in conjunction with midazolam (Versed®)
Short acting anesthetic often used in conjunction with fentanyl (Sublimaze®)
NSAID, may cause gastric erosion and bleeding
Potent anti-inflammatory effect;increased pain for 24 h, rarely causes fat necrosis and skin depigmentation
NSAID, may cause gastric erosion and bleeding
Use with indomethacin Use with misoprostol