Pharmacology for Physios

Question 1

What is involved in taking drugs orally?

Answer 1

• Tablet/capsule swallowed by patient
• Delayed effect (absorbed by gut)
• Timing depends on nursing staff
• Systemic effects

Question 2

What are sublingual drugs?

Answer 2

Dissolved under the tongue, e.g. anti-emetic

Question 3

What are the effects of taking drugs using a central line?

Answer 3

• Rapid distribution through blood supply
• Systemic effects
• Unless via PCA (button) dependent on nursing staff

Question 4

What are the features of patient controlled analgesia (PCA)?

Answer 4

• Usually via central line
• Unlimited patient use as required (button)
• Block out period prevents overdose
• Usage monitored daily by APS
• Systemic effects
• E.g. morphine

Question 5

What are the features of epidural/spinal analgesia or anaesthesia?

Answer 5

• Can mostly selectively block sensory pain pathways (preserving motor)
• Very effective pain control if sited effectively
• Require daily monitoring by APS
• Risks of damage around spinal cord

Question 6

What are the effects of local anaesthetic?

Answer 6

Pain buster balls

• Gradual drainage of anaesthetic around wound site
• Minimal systemic effects
• Patient carries it with them

Question 7

What are analgesics?

Answer 7

• Pain relief
• Commonly through PCA (fentanyl, morphine)
• Oral: Paracetamol, codeine, endone, oxycontin, aspirin

Question 8

How can analgesics affect respiration?

Answer 8

They can potentially reduce respiratory drive (side effect)

Question 9

What are inotropes?

Answer 9

• Increase BP and/or contractility of heart

- Common following cardiac surgery or severe sepsis (whole body suffering from infection, very low BP)

Question 10

How are inotropes administered?

Answer 10

Central line e.g. noradrenaline, adrenaline, dobutamine

Question 11

What are anti-hypertensives?

Answer 11

• Reduce BP
• Long-term or short-term
• Central line or oral
• E.g. captopril, metprolol

Question 12

What should be considered when administering anti-hypertensives?

Answer 12

The patient’s normal blood pressure - 120/70 may feel low to a patient who is normally hypertensive

Question 13

What are anti-arrythmics?

Answer 13

• Stabilise heart muscle
• Particularly used for atrial fibrillation (AF) or atrial flutter
• Oral & IV e.g. amiodarone

Question 14

How do anti-arrythmics work?

Answer 14

Affect sodium & potassium channels causing increased duration of cardiac action potential

Question 15

What are bronchodilators?

Answer 15

• Relax smooth muscle of airways
• Asthma, COPD
• Short acting vs long acting
• MDI (metered dose inhalers aka puffer) vs oral
• E.g. salbutamol (ventolin)

Question 16

What are mucolytics?

Answer 16

• Break down sputum through enzymatic destruction of protein
• CF, bronchiectasis, end of life
• Oral (tablet/liquid) or inhaled
• E.g. mucomyst

Question 17

What are steroids?

Answer 17

• Naturally occurring hormones (adrenal gland)
• Corticosteroids: Anti-inflammatory properties
• Inhaled, oral (tablet/liquid) or IV
• E.g. flixotide

Question 18

What are diuretics?

Answer 18

• Increase urine production
• Fluid overloaded (e.g. APO, kidney failure)
• Heart failure
• Oral, IV or IM (intramuscular)
• E.g. frusemide

Question 19

What are anti-coagulants?

Answer 19

• Blood thinners
• Reduce risk of DVT, PE, stroke, AMI
• Need to monitor clotting levels (INR, PTT)
• Often long term
• Oral or IV
• E.g. warfarin, aspirin

Question 20

What are anti-emetics?

Answer 20

• Reduce nausea & vomiting
• Fast acting
• Routinely prescribed as required following GI surgery
• Sublingual, IV or IM
• E.g. maxolon