Q. A 36-year-old male was admitted for observation yesterday following a 12-foot fall from a ladder. There was brief loss of consciousness, and the patient sustained a head laceration. A thorough evaluation was performed in the emergency department, including a head CT, chest x-ray, and EKG, which were all interpreted as within normal limits. Due to his complaint of chest pain, he was placed on a continuous cardiac monitor, and three sets of cardiac enzymes spaced six hours apart were ordered. Staff report the patient did well overnight and evaluation of his rhythm strip this morning reveals no concerning patterns or dysrhythmias. His cardiac enzymes remain negative.
On physical examination, his blood pressure is 135/85 mm Hg, heart rate 70/min, respiratory rate 18/min, and oxygen saturation is 99 percent on room air. His head laceration required 10 sutures, and on inspection today, the wound is clean, dry, and intact. The patient’s pupils are equal, round, and reactive to light. Assessment of his cranial nerves II through XII is unremarkable and no focal deficits are appreciated. His neck is supple, with full range of motion, and no cervical tenderness is noted to palpation. Pulmonary examination reveals clear breath sounds bilaterally. Auscultation of his heart demonstrates regular rate and rhythm, with no murmurs, rubs, or gallops. On inspection of his chest, you note ecchymosis and mild edema over the sternum extending laterally onto his right anterior thorax. The area is tender to palpation, and the pain is reproducible with deep inspiration and movement. His abdomen is soft, non-tender, with no masses or organomegaly. The patient’s pulses are equal in all extremities, and no edema is present. Based on his history and your assessment, you suspect a secondary diagnosis related to the patient's traumatic injury.
Which of the following medications is most indicated at this time?