Duke PA ortho pharm general info
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| Acetaminophen (tylenol) | Efficacy comparable to aspirin, first line therapy for osteoarthritis. No good antiinflammatory action
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| Aspirin | First NSAID, Irreversible platelet effects
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| Ibuprofen (motrin, rufen, nuprin, advil) | NSAID-200 mg superior to 650 mg aspirin. Better antiinflammatory than acetaminophen.
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| Naproxen(naprosyn)naproxen Na (anaprox,aleve) | NSAID-275 mg Na salt comparable to 650 mg aspirin with slower onset and longer duration
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| Ketorolac (toradol) | NSAID 30-60 mg is comparable to 6-12 mg morphine
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| Celecoxib (celebrex) | Selective COX-2 inhibitor-use sparingly if at all, short term reduction of GI toxicity
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| diclofenac patch (Flector) | Topical NSAID strains, sprains, contusions
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| diclofenac gel (Voltaren) | Topical NSAID approved for osteoarthritis
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| Tramadol | Opioid-adjust for renal function, not a controlled substance
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| Meperidine (demerol/demonal) | Opioid-not recommended. Metabolite causes CNS toxicity, accumulates due to long half-life.
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| Nalbuphine | Kappa-opioid not recommended
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| Butorphanol | Kappa-opioid not recommended
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| Dexocine | Kappa-opioid not recommended
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| Buprenorphine | Kappa-opioid not recommended
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| Pentazocine | Kappa-opioid not recommended
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| Propoxyphene (darvocet/darvocrap) | Opioid-not recommended, efficacy in trials no more than that of 650 mg ASA or APAP. Metabolite accumulation may cause seizures.
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| Used for neuromuscular conditions. Little evidence for use in musculoskeletal conditions | Antispastic
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| Used for musculoskeletal spasms related to injury. Evidence supports SHORT TERM use | Antispasmodic
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| Cyclobenzaprine (Flexeril) | tricylclic antidepressant used clinically as a muscle relaxant/antispasmodic
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| Methocarbamol (Robaxin) | muscle relaxant/antispasmodic
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| Tizanidine (Zanaflex) | muscle relaxant/antispasmodic
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| Carisoprodol (soma) | Muscle relaxant
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| Chlorzoxazone (parafon forte) | muscle relaxant/antispasmodic
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| Tizanidine (zanaflex) | muscle relaxant/antispasmodic
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| Pregabalin (lyrica) | indicated for fibromyalgia
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| Gabapentin (Neurontin) | indicated for fibromyalgia
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| Seldom warranted for back pain | Opioids in general
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| Amitriptyline | Tricyclic antidepressant-low doses indicated for treatment of back pain.
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| duloxetine (Cymbalta) | SNRI-Used for treatment of subacute and chronic musculoskeletal pain
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| venlafaxine (Effexor) | SNRI-Used for treatment of subacute and chronic musculoskeletal pain
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