Drug videos Flashcards
Used for S&S of ischemic strokeo w/in 3 hours of onset of S&S of stroke, used for at leas 4.5 hours; breaks down clot formed in brain; 30% more likely to have minimal or no impairments after 3 months in patients receiving drug
Alteplase
- ADRS: Increased rate or intracerebral hemorrhage, N/V, Low BP, Dizziness, Mild fever, Allergic reactions
What are the PT implications for Alteplase?
- After 24-48 hours of monitoring
- Improve functional outcomes
- Reduces incidents of DVT, muscle contractures, pressure sores, pneumonia, and other infections
- Reduce implications of functional decline
Used for AD; AChE inhibitor (reversibly binds and inactivates AChE); contraindication for hypersensitivity to cholinesterase inhibitor and while talking piperidine derivatives; needs to be monitored for GI bleed; metabolized in liver
Aricept (donepezil)
What are the PT implications for Aricept?
- More ACh = better alertness, memory, thoughts, judgement
- improved cognitive fxn, mood, and fitness level
- Ot may be easier to work with (pt better participate and has more active role in rehab)
Muscle relaxant; Polysynaptic inhibitor and tricyclic antidepressant; for muscle spasms associated with acute, painful musculoskeletal conditions (not effective for spasms caused by CNS disease); inhibit alpha motor neurons; excreted by kidneys, hepatic impairment monitoring; used with fibromyalgia; MAO-I and SSRIs contraindicated
Flexeril (cyclobenzapine)
What are the PT implications for Flexeril?
- relaxes m’s for PT treatment
- Do not over fatigue pt
- be aware of balance/ coordination during exercise
Antimetabolite/ Antifolate/ Antirheumatic/ Antipsoriatic/ Immunosuppressant/ DMARD; used for RA, psoriasis, lupus, cancers, and chronic inflammatory conditions; MOA: inhibits folic metabolism; Blocks dihydrofolic acid reductase, Inhibits synthesis of purines and pyrimidines (Decreases DNA and RNA synthesis); Decreased release of adenosine (Immune functioning); skin sensitivity to singling, do not combine with alcohol, NSAIDS, or take while pregnant/ breastfeed; used widely for osteosarcoma
Methotrexate
A = Oral, IV, IM, SQ, Intrarectal
- can cause liver damage, lung problems, bone marrow suppression
What are the PT implications for Methotrexate?
- assess pulmonary function periodically (measure blood volumes, respiratory sounds and rate)
- Monitor unusual weakness and fatigue (Aplastic anemia)
- Signs of infection, fever, sore throat (Leukopenia)
- Unusual bleeding (Thrombocytopenia)
- Assess musculoskeletal pain – osteonecrosis, stress fx
- RA – assess impairments in pain and ROM and functional ability to document if drug is helping
- Psoriasis or cutaneous fungal infection – assess integrity of skin for lesion
- Assess for dizziness – gait, balance, functional activities
Motion sickness drug, treats stomach, intestinal problems or spasms in PD (palliative care), and produces amnesia, decr. salivations, and excessive respiratory secretions for pre-op; anticholinergic (Blocks ACh) to decrease parasympathetic activity; MOA: reduces secretions of body organs (stomach, intestines), decreases nerve signals that trigger vomitting (vestibular activity reduced)
Scopolamine (Transderm scop, Maldemar)
What are the PT implications for Scopolamine?
- Assess HR and heart sounds during exercise - Tachycardia, arrhythmias, chest discomfort, shortness of breath, fainting, fatigue/weakness
- Be alert for decreased sweating and increased body temperature during exercise
- Assess for signs of urine retention or difficulty urinating - Notify MD
- Drowsiness – potential falls
Used for OA; after conservative therapy fails and before joint replacement; hylauronan derivatives injected into joint to act as a lubricant and shock absorber
DMOAD (synvisc)
What are PT implications for DMAODs?
decreases pain so pt is more able to participate in strengthening muscles/ weight loss to help with OA symptoms
Used for anxiety; benzodiazepine; enhances effects of GABA; can cause withdrawal and addiction
Xanax
What are PT implications for Xanax?
there can be high levels of anxiety with tx, so will help pt calm and be more relaxed when taken before PT
SSRI antidepressant (for Major depression, OCD, PTSD, Generalized anxiety disorder, Separation anxiety disorder, Hot flashes, Premature ejaculation , Pruritis)
Zoloft (sertraline HCL)
Used for relapsing remitting MS and secondary progressive MS; interferon beta 1a;: reduce activity of macrophages and lymphocytes responsible for destruction of glial cells and neuronal structures in MS (may have favorable effect on demyelination) Many drug interactions (baclofen, ambient, ibuprofen, zoloft contraindications); injection
Avonex
- ADRs :
absolute contraindication for hypersensitivity to interferons or albumin
Serious: Psychiatric disorders, Anaphylaxis, Pancytopenia, Thrombocytopenia, Seizures, CHF, Autoimmune disorders, Hepatotoxicity, Viral transmission risk, Spontaneous abortion
Common: Flu-like symptoms, Myalgia at injection site, UTI, Anemia, Paresthesia, Myasthenia
What are PT implications for Zoloft?
- Myalgia, Muscle tension , Joint/muscle pain
- Depression or anxiety – goals to increase exercise to reduce symptoms
- Allows pt. to engage in human environment
- Decrease pain and immobilization
- Stroke impairments
What are PT implications for Avonex?
- Used with PT for improving function of pt
- Stretching and strength exercises
- management of LE weakness and gait
- Assess balance, coordination, spasticity (drug effective in MS reduction)
- Monitor for ADRs (jaundice)
Used for spasticity; acts on spinal cord to reduce hyperactive reflexes and excessive muscle tone; can cause overdose, withdrawal symptoms and rhabdomyolysis; MOA: acts on GABA-B receptors to inhibit mono- and polysynaptic reflexes
Baclofen - ITB pump
Pump – unresponsive for oral baclofen or at highest max dose with need for more; Gives lower dose with less side effects – skips systemic and goes straight to spinal cord
What are PT implications for Baclofen ITB pump?
- Controls spasticity to increase strength, ROM, and function
- Avoid sudden excessive repeated movements
- Pump can become dislodged, kinked, or blocked
- Heat, US, hot tubs, steam room, sauna – avoid; Increased body temp = increased flow rate of drug
Used for Moderate-severe RA, Crohn’s disease, Plaque psoriasis, Ankylosing spondylitis, Psoriatic arthritis, and Ulcerative colitis; MOA: Selectively binds to TNF-alpha to prevent from binding to surface receptors, Inhibits synthesis of proinflammatory cytokines, and Delays progression of RA; injection
Humira (Adalimumab)
- usually used with methotrexate after it methotrexate did not work alone
What are PT implications for Humira?
- Signs of infection
- Injection site reactions
- ADRs: increased risk of infection, rash, liver damage, lymphoma, TB, CV disorders
- Compliance with use
Used for relapsing forms of MS; SQ injection; MOA: Glatiramer acetate – synthetic compound that insulates nerve fibers, Stimulates new myelin growth, and Blocks T cells from damaging CNS myelin further; ADRs: vasodilation, injection site retains, rash, dyspnea, cheese pain, flulike symptoms, vision problems
Capaxone
What are PT implications for Capaxone?
- Timing around drug administration due to side effects right after
- Less relapses/impairments from MS
- Avoid irritation or pressure over injection sites
- Monitor effectiveness of drug and proper injection
used for control of seizures, tx of insomnia, anxiety relief, prevent withdrawal sx from barbiturate dependencies; barbiturate schedule IV drug; MOA: acts on GABA receptors to increase synaptic inhibition (alleviates seizure threshold), inhibits CA channels, resulting in decreased excitatory transmitter release (CNS depressant)
Phenoarbtial
What are PT implications for Phenoarbital?
- Monitor hypersensitivity reactions
- Assess for bronchospasm and laryngospasm
- Daytime drowsiness – fall risk
- Look for depression, delirium, alterations of mood or behavior
- Document seizures
- Assess BP
- Injection sites for reactions
What are PT implications for levadopa?
- Improves motor symptoms
- Causes dyskinesia – look for in patients
- Improve fitness level, strength, flexibility
- Develop effective transfer strategies
- Improve walking coordination
- Improve hand movement ability
- Increase ADLs and participation in activities
- “Big and loud”
Drug for spasticity; MOA: blocks poly- and monosynaptic afferent pathways, hyper polarizes primary afferent terminals to inhibit the release of excitatory neurotransmitters; Oral administration, metabolized by liver; OD leads to respiratory depression; contraindicated in stroke, CP, ad PD
Oral baclofen
What are PT implications with oral baclofen?
- Do not use in pts who require spasticity for function
- Will have weaker muscles while taking drug
- Better results when drug use is combined with PT
Used to prevent and treat osteoporosis, treat Paget’s disease, and treat glucocorticoid-induced osteoporosis; Biphosphonate - binds to bone inhibiting osteoclast mediated bone resorption; beneficial for up to 5 years, benefit diminishes over time
Fosamax
- weird contraindications: hypocalcemia, need strong esophagus, upper GI, and have no risk of aspiring drug
What are PT implications for Fosamax?
- Exercise – increases osteoblast activity
- Weight bearing and resistance training
- Improve balance, safe ambulation, decrease fall risk
- Improve posture
Used for spasticity, bladder dysfunction, chronic migraine, cervical dystonia excessive axillary sweating, blepharospasm and strabismus; injected; binds to the NMJ, autonomic ganglia, postgangluonic parasympathetic nerve endings, and postganglionic nerve endings that release ACh (prevents release of ACh)
Botox
What are PT implications with Botox?
- PT can help assist with effects of decreased tone and improved functions from the botox injections
- Increased balance and ROM
- Enhance pt abilities before injection wears off
Used for depression; MAO-I, not a 1st choice, but used with failed responses to other drugs; oral tablet; lots of contraindications
Phenelzine (Nardil)
What are PT implications of Phenelzine (Nardil)?
- May influence fatigue and exercise performance
- Consider CV and pulmonary effects
- Neurological symptoms – parkinsonism, acute dystonia
- Be aware of serotonin toxicity
- Exercise to overcome depression
- Increase mood and confidence
