Drugs

Question 1

opiods

Answer 1

• Pain relief, postoperative pain, cough relief (antitussive)
• Examples: morphine, oxycodone, hydrocodone
• Take medication 30 min prior to therapy
• Side effects
  ◦ Respiratory and CNS depression, bradycardia, constipation, slowed breathing, dizziness, drowsiness, slowness, addiction,
  tolerance

Question 2

NSAIDs

Answer 2

• Pain relief; analgesic, anti-inflammatory, antipyretic, and antithrombotic effects
• No sedation effects, unlike opioids
• Examples: aspirin, acetaminophen (brand name: Tylenol), ibuprofen (brand names: Motrin, Advil), naproxen (brand names:
  Aleve, Naprosyn), celecoxib (brand name: Celebrex)
• Side effects
  ◦ GI disturbance, diarrhea, constipation, nausea, vomiting, reduced appetite, ulcers, bleeding, perforations
  ◦ Acetaminophen overuse causes liver damage, leading to jaundice and clay-colored stools → no more than 6 tablets
  (500 mg) per day for adults

Question 3

Antiarthritic agents

Answer 3

• Prevent and suppress arthritis
• Examples: gold-containing compounds (eg, auranofin [brand name: Ridaura]), etanercept (brand name: Enbrel), hyaluronic
  acid injections (brand name: Synvisc)
• Side effects
  ◦ Skin: dermatitis, pruritus, allergic reactions that may lead to anaphylactic shock
  ◦ Diarrhea, stomatitis, pharyngitis, laryngitis, colitis
  ◦ Bronchitis, interstitial pneumonitis
  ◦ Vaginitis, nephrotic syndrome

Question 4

Anticonvulsant drugs

Answer 4

• Used to control seizures; generalized CNS depression
• Examples: carbamazepine, clonazepam, diazepam, phenobarbital, phenytoin
• Side effects
  ◦ Drowsiness, ataxia, sedation, GI disturbances, rash, weakness, hypotension

Question 5

Skeletal muscle relaxants

Answer 5

• Reduce muscle spasms
• Examples: carisoprodol (brand name: Soma), cyclobenzaprine (brand name: Flexeril), methocarbamol (brand name: Robaxin),
  orphenadrine (brand name: Norflex)
• Side effects
  ◦ Sedation
  ◦ Dizziness
  ◦ Dry mouth

Question 6

Anti-Parkinson agents

Answer 6

• PT session should be scheduled to coincide with maximal effectiveness of drugs

◦ Levodopa should be administered 1 h before PT session
* Example: Levodopa/carbidopa combination (brand name: Sinemet)
* Side effects
◦ Orthostatic hypotension
◦ Nausea
◦ Dry mouth
◦ Dizziness
◦ Fluctuations and “wearing off” of benefits between doses
◦ Dyskinesias

Question 7

Antiepileptic drugs

Answer 7

• Also used to treat peripheral neuropathy
• Example: pregabalin (Lyrica)
• Side effects:
  ◦ CHF, lymphedema
  ▪ Check for sock markings
  ◦ Difficulty walking long distances

Answer 8

• Loop diuretics: furosemide (brand name: Lasix)

◦ Inhibits reabsorption of water and electrolytes from the loop of Henle
◦ Side effects: hypokalemia, hypocalcemia, hyponatremia, dehydration, orthostatic hypotension, reflex tachycardia,
dizziness, lethargy
* Potassium-sparing diuretics: spironolactone
◦ Binding of receptors at the aldosterone-dependent sodium–potassium exchange site at the distal convoluted renal tubule
◦ Side effects: hyperkalemia, dizziness, orthostatic hypotension, dehydration, reflex tachycardia, gynecomastia
* Thiazides: HCTZ
◦ Blocks the sodium and chloride channels at the distal convoluted tubule of the nephron
◦ Inhibits sodium and water reabsorption
◦ Side effects: hypercalcemia, hypokalemia, hyperuricemia, hyperlipidemia (avoid with the elderly), dehydration, orthostatic
hypotension, reflex tachycardia, dizziness, lethargy, DM, renal dysfunction