Pharmacology in Sports Physical Therapy Flashcards
What are Pharmacokinetics and Pharmacodynamics
- Pharmacokinetics - What the body does to the medication
- Pharmacodynamics - What the medication does to the body
What are the phases of Pharmacokinetics
- Absorption (Administration)
- Distribution
- Metabolism
- Excretion
What are Enteral and Parenteral Administration of drugs
- Enteral - utilizes the gastrointestinal
tract and includes the oral, sublingual,
buccal and rectal routes of administration - Parenteral - “around” the enteral tract
What are Sublingual and Buccal forms of Enteral drug administration?
- Sublingual - Dissolved under the tongue
- Buccal - Between the Cheek and Gums
What are Parenteral forms of drug administration?
- Injections (IV, Intra-Articular, Subcutaneous)
- Inhaled and Intranasal
- Transdermal
How would you administer Valium to an athlete with acute status epilepsy?
- Rectally
What would administer to an unconscious
athlete experiencing hypoglycemia?
- IM Glucagon
What would you administer to an
athlete experiencing an acute anaphylactic allergic
reaction to food or bee stings?
- IM Epinephrine
What are Clearance (elimination) of a drug and Half Life?
- Clearance is the combination of Metabolism and Excretion of the Drug
- Half Life is how long it takes the body to clear 50 percent of the drug
What is the dose response relationship?
- the relationship between the amount of drug in the body and the expected effectiveness and likelihood and severity of side effects. In other words, the higher the dose, the higher the risk of side effects.
What is a narrow therapeutic window?
- the concentration of drug required to exert the preferred response is very close to the concentration at which toxic events are likely.
- Drugs with wide therapeutic windows are safer and easier to dose.
What are some examples of drugs with narrow therapeutic windows?
- Anti-coagulants
- Anti- Seizure
- Thyroid Medications
- Narrow therapeutic window drugs often require close monitoring by a physician
What are some categories of NSAIDS?
- non-acetylated salicylates (e.g., salsalate)
- first-generation NSAIDs (e.g., ibuprofen)
- COX-2 inhibitor (e.g., celecoxib/Celebrex).
How do NSAIDs Work?
- Inhibit the enzyme COX 2, and thereby inhibit the production of prostaglandins
What are some NSAID-related gastrointestinal
adverse effects?
- dyspepsia
- heartburn
- nausea
- abdominal pain
- peptic ulcer
- gastrointestinal bleeding
In an Athlete taking NSAIDS, what symptoms should they report to the physician
- any stomach pain
- dark black, tarry or bloody stools
- vomiting of blood or matter that looks like coffee grounds
How long should an athlete take NSAIDs before talking to physician to make sure it is ok?
- Ten Days
What NSAIDs have a lower risk of GI complaints?
- Cox 2 Inhibitors
- non-acetylated salicylates
- Topical (Flector Patch, Voltaren Gel, Pennsaid topical solution)
Which NSAIDs have anti-platelet effects?
- First-generation NSAIDs and especially aspirin
- Not so much with non-acetylated salicylates and COX 2 inhibitors
Athletes under the age of eighteen should not take aspirin or salicylates…..Why?
- Risk of developing Reye’s Syndrome, a rare but potentially fatal neurological disorder complicated by hepatic dysfunction.
What is the major health concern when using Acetaminophen?
- Liver Toxicity
What products typically contain Acetaminophen?
- Cold/ Cough Products
- headache/migraine products
- sinus products
- some sleep aids
- prescription opioid/acetaminophen combination products
What is the maximum daily dose of Acetaminophen?
- 4 grams
What are some common opioid withdrawal symptoms?
- body aches
- diarrhea
- insomnia
- irritability
- shivering
- sweating
- runny nose
- tachycardia
What are the timelines for Opioid Withdrawal symptoms?
- Usually occur within six to ten hours
after the last dose, and peak on day two or three. - Symptoms of withdrawal may last for up to five days
following the last dose.
What are some common inhaled corticosteroids to treat asthma?
- beclomethasone (QVAR)
- budesonide (Pulmicort)
- ciclesonide (Alvesco)
- fluticasone (Flovent)
- mometasone (Asmanex)
What are some localized averse effects of inhaled corticosteroids?
- oropharyngeal candidiasis
(thrush) - dysphonia (difficulty speaking)
- These are decreased by washing out the mouth or using a spacer
What are some long term adverse effects of inhaled corticosteroids?
- growth suppression in children
- osteoporosis
- cataracts
- dermal thinning
- adrenal insufficiency and crisis
What is the most commonly prescribed rescue inhaler? (Bronchodilator)
- Albuterol or Levalbuterol
What are some long acting Beta-2 agonists used to treat asthma? (Bronchodilator)
- Salmeterol and Formoterol
- Slow acting, not to be used as rescue inhaler
- Twice Daily for prevention
What are some adverse effects of inhaled bronchodilators?
- tremor
- nervousness
- dizziness
- headache
- nausea
- tachycardia
What is Cold Induced Exercise Induced Bronchospasm?
- Exercise in cold dry air produces bronchoconstriction, with wheezing occurring within just a few minutes
- Warm-up period before exercise may reduce the severity of EIB, and wearing a covering over the mouth may alleviate cold-induced EIB
What are the main active ingredients of topical antifungal medications?
- Clotrimazole
- Miconazole
- Tolnaftate
- Terbinafine
- Butenafine
What is Tinea Corporis?
- Ringworm
- Causes keratin breakdown of the skin around a lesion resulting in a ring-shaped, red-colored skin rash, often with itching that can occur in any area of the skin, including the arms, legs, face and groin.
What is Tinea Capitis?
- Ringworm of the Scalp
What is Tinea Pedis?
- Athletes Foot
- Begins in the crease of the toes and can spread to other areas on the dorsum and sole of the foot. As the condition worsens, a dry, red and cracking appearance of the skin occurs
What is Tinea Cruris
- Jock Itch
- Superficial fungal infection of the groin area and crural
skinfolds - Usually spares the penis and scrotum
- More common in men than women
- Symptoms include a red, raised plaque with distinct margins and itching.
Can you treat Ringworm of the Scalp with topical Antifungals? Explain.
- No
- Because the infection resides within the hair follicles; therefore, systemic oral antifungal drugs are required.
How is diabetes in the Athlete related to fungal infections?
- Glucose in perspiration may promote fungal
growth
What is Impetigo?
- Caused by gram positive pathogens, Group A Streptococcus or Staphylococcus aureus
- Typically has a rash-like appearance with yellowish-brown or honey-colored serous crusting and sometimes includes superficial blisters that rupture
easily and “weep”
How is Impetigo typically treated?
- Topical and/or oral antibiotics that target gram positive
pathogens including: - Mupirocin (Bactroban) and Neosporin
- Or oral antibiotics such as:
- Cephalexin (Keflex), azithromycin (Zithromax), and
sulfamethoxazole/trimethoprim (Bactrim)
