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National Physical Therapy Examination: Pediatrics > Pediatrics: Cerebral Palsy: Medical, Surgical, Pharmacological Interventions > Flashcards

Pediatrics: Cerebral Palsy: Medical, Surgical, Pharmacological Interventions Flashcards

1
Q

Pharmacological: Oral Medications Purpose

A
  • Pre-synaptic inhibition of acetylcholine release
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2
Q

Pharmacological: Baclofen: Site of action

A
  • Central Nervous System
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3
Q

Pharmacological: Baclofen: Pros

A
  • Decreases spasticity and spasms
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4
Q

Pharmacological: Baclofen: Cons

A
  • Decreased strength

- May lose postural control

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5
Q

Pharmacological: Diazepam: Site of action

A
  • Central Nervous System
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6
Q

Pharmacological: Diazepam: Pros

A
  • Improves motor control
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7
Q

Pharmacological: Diazepam: Cons

A
  • Difficult to maintain steady state
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8
Q

Pharmacological: Tizanidine: Site of action

A
  • Central Nervous System
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9
Q

Pharmacological: Tizanidine: Pros

A
  • Noninvasive

- Not permenant

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10
Q

Pharmacological: Tizanidine: Cons

A
  • Following dosage schedule may be difficult
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11
Q

Pharmacological: Dantrolene: Site of action

A
  • Muscle
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12
Q

Pharmacological: Dantrolene: Pros

A
  • Can be effective for some patients
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13
Q

Pharmacological: Dantrolene: Cons

A
  • Side effects of drowsiness, hypotonia
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14
Q

Pharmacological: Intrathecal Baclofen Pump

A
  • Catheter delivers drug to the intrathecal space
  • Baclofen is a GABA b-agonist, which in an INHIBITORY CNS neuro transmitter
  • Intrathecal administration allows for less medication to be administered
  • Baclofen is a muscle relaxer
  • Can be administered at a specific spinal level and relax muscles below that level
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15
Q

Pharmacological: Intrathecal Baclofen Pump: Pros

A
  • Longer lasting
  • Decreased spasticity/spasm
  • improves motor control
  • Reversible
  • Non-invasive dose
  • Fewer side effects
  • Reservoir holds 1-4 month supply
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16
Q

Pharmacological: Intrathecal Baclofen Pump: Cons

A
  • Side effects can include hypotonia
  • Nausea
  • Headaches
  • Catheter kink/malfunction
  • Overdose and withdrawal
  • Refills needed approx every three months
17
Q

Pharmacological: Intrathecal Baclofen Pump: Red Flag

A
  • Abrupt withdrawal of Baclofen may result in exaggerated rebound effects
18
Q

Neurosurgery: Selective Dorsal Rhizotomy

A
  • Abnormal dorsal sensory nerve roots are severed
19
Q

Neurosurgery: Selective Dorsal Rhizotomy: Pros

A
  • Decrease spasticity
  • Improved motor control
  • Not reversible
20
Q

Neurosurgery: Selective Dorsal Rhizotomy: Cons

A
  • Possible sensory loss
  • Not reversible
  • Not effective for Dystonia
  • Anesthesia risks
21
Q

Peripheral Nerve Block

A
  • Injection of phenol into peripheral nervous system from nerve root to motor end plate
  • Lasts 3-6 months
22
Q

Peripheral Nerve Block: Anesthetic/Diagnostic Nerve Blocks: Pros

A
  • Decreases local spasticity and dystonia
  • Not permanent
  • Decreases contracture
  • Improves motor control
  • Not systemic
23
Q

Peripheral Nerve Block: Anesthetic/Diagnostic Nerve Blocks: Cons

A
  • Not permanent
24
Q

Peripheral Nerve Block: Neurolytic Nerve Blocks: Pros

A
  • Decreases local spasticity and dystonia
  • Not permanent
  • Decreases contractures
  • Improves motor control
  • Not systemic
25
Q

Peripheral Nerve Block: Neurolytic Nerve Blocks: Cons

A
  • Not permanent

- Ethanol and Phenol - great skill is needed to inject, risk of paresthesias

26
Q

Botox

A
  • Minute amounts of botulinum toxin injected into the muscle paralyzing it for 4-6 months
  • Only a certain amount of botulinum toxin can be given in one sitting. If spasticity is wide spread intrathecal infusion may be a better option
27
Q

Botox: Pros

A
  • Decreases local spasticity and dystonia
  • Not permanent
  • Decreases contracture
  • Improves motor control
  • No systemic effects
  • Can be administer without anesthesia
  • Lasts 4-6 Months
28
Q

Botox: Cons

A
  • Not permanent
  • Expensive
  • Hypotonia

National Physical Therapy Examination: Pediatrics (18 decks)

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