ABSTRACT
Orthopaedic surgeons should have a sound working knowledge of the indications for, and the actions and adverse effects of, any therapeutic drug that they prescribe on a regular basis. This chapter provides an overview of the common classes of drugs encountered by orthopaedic surgeons. Paracetamol is generally considered to be a weak inhibitor of the synthesis of prostaglandins. A progressive approach is used, starting with simple analgesics such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), supplemented first by weak opioid analgesics and later by strong opioids. Aspirin is an irreversible inactivator of COX, acting by acetylating a serine residue in the active site of the enzyme. In orthopaedics, glucocorticoids are used for a variety of different indications: intraarticular injections for arthritis, peri-operative dosing for patients on long-term steroids, symptom relief in rheumatoid arthritis and for spinal cord injuries. Inhalation anaesthetics are volatile liquids or gases that depress the CNS. Anticoagulants are used in the prophylaxis and treatment of thromboembolism.
