These blog posts have attempted to bridge the gap between our patients and our providers by answering the most commonly asked questions we hear on a daily basis. As I find myself working in our Nursing Triage department, I have come to realize that one of the largest gaps is in the realm of pharmacology. I am on a mission to bridge that gap that exists in the hopes that you feel as strongly as I do that at Orthopaedic Associates of Wisconsin, there really is a difference in the care we provide. The best way to be involved in your own medical care is to be knowledgeable and educated about the conditions you have and the treatment provided, so here we go with OAW Pharmacology 101!
One of the most common types of medications we prescribe is the anti-inflammatory drug (NSAID). These medications can be over-the-counter or prescription strength. OTC examples are ibuprofen (brand name: Advil) and naproxen (brand name: Aleve). These medications should be taken according to the dosing instructions on the bottle and with food and water to protect your gastrointestinal system. Prescription strength oral NSAIDS include diclofenac, meloxicam, piroxicam, ketorolac, and indomethacin, to name a handful. A topical version of diclofenac is available as well. NSAIDS are prescribed to treat inflammatory conditions such as arthritis or tendinitis. These medications should not be intermixed as they are all in the same class. Patients who have kidney and liver issues or who take blood-thinning medications for a heart condition typically cannot take anything in this class of medications. Even in otherwise healthy patients, we ask that they have blood work completed every six months to ensure that the body continues to metabolize the medication effectively.
We are a surgical practice, so we prescribe a fair amount of pain medication to include oral narcotics for patients after they endure some kind of invasive procedure. Our preferred non-narcotic pain medication is OTC tylenol. Because tylenol is not an NSAID, it can be used in conjunction with the medications described above to help with breakthrough pain, but some narcotic medications contain tylenol so always ask your prescriber. You can take up to 3,000 milligrams per day total.The oral narcotics we prescribe are only used after operative procedures or in cases of severe injury being treated conservatively. Long-term narcotics require establishment with a pain management specialist. Examples of narcotics include oxycodone, hydrocodone-acetaminophen, and tramadol. These medications are only to be used as needed for pain and are not intended to eliminate pain, but rather make it tolerable enough to allow rehabilitation and daily activities to occur. Prescribing this class of medication requires a continued dialogue between the patient and the doctor to ensure that the appropriate strength and dosing is provided. Narcotics come with the risk of nausea, constipation, respiratory depression, sedation, decreased blood pressure, and addiction, so we monitor those prescriptions particularly closely.
Because we prescribe medications that can result in nausea, vomiting, and constipation, we also sometimes prescribe medications to counter those adverse effects, especially after a surgery. We prescribe ondansetron to help with post-operative nausea whether it is caused from the anesthesia or the pain medication itself. We often prescribe stool softeners after surgery to help patients counter narcotic-induced constipation that could lead to a bowel obstruction. These medications are short-term and should be used as prescribed.
Our realm of healthcare also requires antibiotics on a fairly regular basis to treat and prevent infections. We use antibiotics intra-operatively to decrease the risk of developing an infection. Sometimes complications arise that create wound issues that require continued oral antibiotics. Other times antibiotics are prescribed prophylactically when an increased risk of infection exists such as when someone with a total joint replacement goes to the dentist. The antibiotic prescribed is largely based on the type of bacteria present.
Regardless of the type of medication being prescribed, we want to make sure you know what it is and why we are prescribing it. If you are confused or concerned, we welcome any and all questions!
This blog is written by one of our very own-Morgan. She is a certified athletic trainer working as a medical assistant with our providers each and every day in our clinic. She obtained a bachelor's degree in athletic training from Carroll University in Waukesha and a master's degree in Kinesiology from Michigan State University. She is excited to bring you updates and information about the happenings at OAW.