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PT - Ortho Class 1 > Lecture Pharmacology > Flashcards

Lecture Pharmacology Flashcards

1
Q

define: pharmacoprophylaxis

A

use of drugs to prevent disease, or slow the course of a disease

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2
Q

define Pharmacodiagnostics

A

pre-treatment testing to determine patient response to a drug therapy

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3
Q

define pharmacokinetics

A

how the body deals with a drug in terms of the way it is administered, absorbed, distributed, and eliminated

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4
Q

define pharmacodynamics

A

what a drug does to the body, including the mechanism by which it exerts its effect

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5
Q

define toxicology

A

the study of the harmful effects of drugs (incl. medication, toxins & poisons)

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6
Q

what are 3 classifications of drug naming?

A

chemical, brand/trade, generic

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7
Q

describe the dose response curve

A

Threshold dose - dose at which the response begins to occur

Potency - dose required to produce a given response

Maximal efficacy or Peak response – maximum amplitude of response (coincides with ceiling effect)

Ceiling effect – plateau effect in the curve, indicating that no further response occurs beyond the given dose

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8
Q

describe administration types (pharmacokinetics) - advantages and disadvantages

A

Enteral administration means that drug enters the body via the alimentary canal.
Parenteral administration means that the drug enters the body through non-alimentary routes.

First-pass inactivation means that the drug entering the enteral route will be metabolized by the liver before reaching its target site. Thus dosage must be adjusted to ensure adequate amount of drug reach the tissue after being partially metabolized by the liver.

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9
Q

describe bioavailability

A

The bioavailability of a drug is the extent to which the drug reaches the systemic circulation, and is expressed as a percentage of the drug administered that reaches the bloodstream. For example, for a 100mg dose, if 50mg eventually reaches the bloodstream, that drug is said to be 50% bioavailable.

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10
Q

what does bioavailability depend on and what are the 4 ways it can occur?

A
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11
Q

explain drug distribution

A
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12
Q

explain drug storage

A
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13
Q

describe pharmacokinetic elimitation

A
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14
Q

describe pharmacokinetic elimination rate

A
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15
Q

describe individual drug responses

A
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16
Q

describe drug receptors

A
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17
Q

NSAIDs - what it does, properties, and adverse effects

A
  • inhibits COX (1 and 2) enxymes, except for COX-2 selective NSAIDs which inhibits only COX2

four general properties:

 Anti-inflammatory - reduce inflammation

 Analgesic - reduce mild to moderate pain

 Antipyretic - reduce elevated body °T (fever)

 Anticoagulant - reduce blood clotting (platelet aggregation) **COX-2 selective NSAID doesn’t do this

primary adverse effects of this family of NSAIDs are:

 Gastrointestinal damage

 High dose: liver damage

 Renal problems in patients with impaired renal function

 Reye syndrome in children

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18
Q

NSAIDs guidelines for musculoskeletal injuries

A
  • interferes with normal inflammatory response and therefore should avoid use within first 48 hours post-injury (avoid use over 5 days)
  • not more effective than simple analgesic (tylenol)
  • NOT recomended for DOMS (use simple analgesic instead)
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19
Q

NSAIDs implication for rehab

A
  • therapy sessions can be conducted but use caution
  • ask when drug last taken when doing therapy with client
  • don’t push too much
20
Q

acetaminophen implications for rehab

A
  • therapy sessions can be conducted but use caution
  • ask when drug last taken when doing therapy with client
  • don’t push too much
21
Q

acetamenophen - properties and adverse effects

A

properties:

Analgesic - reduce mild to moderate pain

Antipyretic - reduce elevated body °T (fever)

The main risk of Acetaminophen is liver toxicity, but this is only a concern if taken at excessively high dosage, or for prolonged period of time (see bottle for directions). This does, however, mean that Acetaminophen is NOT indicated for patients with pre-existing liver problems.

22
Q

glucocorticosteroids - implications for MSK rehab

A
  • helps with symptoms but does not releive cause (cortisone shot)
  • often told to do physio 3-7 days after injection (not right away!)
  • avoid direct weight on joint right after injection

*note there is an injection for frozen shoulder which is a different form of injection and should be moved right away

23
Q

glucocorticosteroid properties and adverse effects

A
  • powerful anti-imflammatory properties
  • immunosuppresive effect (used therapeutically in rheumatologic conditions)

side effects: - note never the first line of treatment

Post-injection “flare” (injection); a short-term worsening of signs and symptoms

Inhibition of collagen synthesis (impaired healing)

Infection (injection)

Avascular necrosis of femoral head (oral)

24
Q

opiod analgesics - properties and side effects

A

properties: Treatment of moderate to severe pain, Anesthesia, Cough suppression, treatment for overdose/addiction

side effects:

 Respiratory depression

 Sedation/ confusion/ dizziness

 Nausea & vomiting

 Constipation

 Hypotension

*risk of developing drug tolerance, dependence or addiction

25
Q

describe the opiod analgesic administration process

A
  • orally is more varied than with PCA
  • initial does is large (loading dose) with subsequenct smaller doses (demand dose), lockout interval to prevent OD, monitor successful vs total demand (how many times button pushed vs how many times delivered), could also have a background (constant) infusion rate
26
Q

opiood analgesics - implications for rehab

A

treatment possible but note these meds may cause:

–Sedation

–Hypotension

–GI discomfort and constipation

–Blunted respiratory response to exercise

–Withdrawal Sx may mimic MSK problem

27
Q

skeletal muscle relaxants - use and side effects

A

use: to treat muscle spasm, purpose to decrease muscle tone

side effect: drowsiness and dizziness (from cns sedation)

28
Q

skeletal muscle relaxants - implications for rehab

A
  • schecule therapy for when sedative effects are at their lowest
  • during treatment work on improving posture, mody mechanics, ms strength, and flexbility
29
Q

general anesthetics - properties and adverse effects

A

use: for sedation for extensive surgical procedures, produce a progressive, reversible CNS depression (loss of consciousness and sensation, amnesia, skeletal muscle relaxation, and inhibition of sensory and autonomic reflexes)

adverse effects: sedation, confusion, muscle weakness (ataxia), respiratory compromise, hypotension

30
Q

general anesthetics - implications for rehab

A
  • monitor side effects (esp muscle weakness)
  • effects should lessen with time, call physician if effects prolonged
31
Q

local anesthetics - purpose and side effects

A

produce localize anesthesia (loss of sensation) and block afferent nerve transmission for surgical procedures

side effects: CNS (confusion, agitation, restlessness), CV (hypotension, bradycardia, reduced cardiac output)

32
Q

local anesthetics - implications for rehab

A

–Loss of sensory feedback (tactile, proprioceptive)

–Possible motor impairment

–Be aware of impairment due to systemic distribution (refer to side effects)

–Non-life-threatening effects will ↓ with time

33
Q

what is Hyaluronic acid therapy?

A
  • 1-5 injections, adverse affects mostly just due to injection site, can last up to 6 months
  • can be used as conservative measure before hip or knee replacement surgery
34
Q

antihyprtensive drugs - implications for rehab

A

–Be alert during positional changes or env °T changes

–Provide a cool-down period following exercises

–Monitor BP & HR before exercise

–Monitor HR during aerobic activity, use RPE if pt is on Beta-blockers

–Allow ↑ time to complete aerobic activity to prevent dyspnea & account for depressed cardiac activity

–Have pt check glucose level prior to exercise if taking hypoglycemic drugs

35
Q

antihypertensive drugs - side effects

A

–Orthostatic hypotension

–Bronchoconstriction, blunting early manifestations of hypoglycemia with Beta-blockers

–Diuretics can cause hypokalemia (low blood K+)

–Depression of HR and contractility

36
Q

what are other drugs with similar side effects / consideration as antihypertensive drugs

A
37
Q

Antithrombotic drugs - what they do, SE, and implications for rehab

A

Effect: inhibit clotting mechanism in blood

side effects: myalgia (muscle pain), arthralgia (joint pain), bleeding

Implications:

–Myalgia and arthralgia may ↓ function of pt during rehab

–Keep an eye on new bruises

–↑ bleeding may alter some wound care activities

38
Q

Antihyperlipidemic drugs - what they do, SE, and implications for rehab

A
  • lower lipid levels

SE: myalgia, arthralgia and ms weakness

implications:

–Function may be ↓ because of pain

–Needs to differentiate between pain from meds and pain associated with ex’s

39
Q

Sedative-Hypnotic drugs - what they do, SE and implications

A

Anti-anxiety agents, Sleep disturbances

SE: Sedation, ↓ arousal or alertness, Motor control dysfunction

implications:

–Plan therapy session depending if drug is beneficial or non-beneficial for therapy

–Education about risks of fall especially in older adults

40
Q

Antipsychotic drugs & lithium - what they do, SE, implications

A

Used to treat Schizophrenia, other psychoses or agitated states & bipolar disorders

SE: Sedation, Orthostatic hypotension, Bradykinesia, tremor, rigidity, Balance and posture problems

Implications for rehab:

–Be careful with positional changes

–Be aware of any changes in posture, balance or involuntary mvts

–Monitor psychosocial factors

41
Q

Antidepressants - used for, SE, implications

A
  • mood improvement and to treat chronic pain

SE: Sedation, hypotension, Hypertensive crisis

Implications for rehab:

–Be careful with positional changes

–Monitor BP during exercise

–Monitor psychosocial factors

42
Q

Drugs for thyroid dysfunction - use, SE, implications

A

Hypo or hyperthyroidism

SE: Exercise intolerance, Intolerance to temperature changes

Implications for rehab

–May have ↓ capacity for aerobic activities

43
Q

Diabetic patients- medication, implications for rehab

A

use Insulin injections or Oral hypoglycemics

SE: Hypoglycemia (mainly from insulin), Nausea and vomiting, Weight gain, MI and heart failure

Implications for rehab:

–Watch for signs of hypoglycemia during therapy: Confusion, visual disturbances, seizures (uncommon), loss of consciousness (uncommon), heart palpitations, shakiness, anxiety, sweating, hunger, tingling sensation around the mouth

–Monitor blood glucose, blood pressure and HR prior to exercise

44
Q

Antibacterial agents - side effects and implications for rehab

A

SE:

–Most common: hypersensitivity or allergic reactions and GI problems

–Many have drug interactions

–IV infusion of certain drugs may cause phlebitis

–Fluoroquinololes may cause tendonitis

–Inhibition of red blood cells, white blood cells, platelets

–Dizziness & vertigo

Implications:

–Do some research on drugs that pt is taking

–Be aware of signs of phlebitis (imflammed walls of veins)

–Avoid high intensity RT ex’s in pt taking fluoroquinololes (risk of tendon rupture)

45
Q

Drugs for upper airway problems - SE and implications

A

rpe = rating of perceived exertion

PT - Ortho Class 1 (9 decks)

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