Year 2: pharmacology: of the musculoskeletal system Flashcards
Pharmacology of the musculoskeletal system
the basic area of pharmacology that deals with drug administration, absorption, distribution, tissue binding, metabolism, and excretion.
AKA “what body does to the drug.”
Pharmacokinetics
Pharmacology of the musculoskeletal system
analysis of what the drug does to the body, including the mechanism by which the drug exerts its effect
Pharmacodynamics
Pharmacology of the musculoskeletal system
These agents provide analgesia for acute severe pain management. The medication stimulates mu, kappa, delta, and sigma receptors within the CNS to prevent pain impulses from reaching their destination. Certain drugs are also used to assist with dependency and withdrawal symptoms.
Opioid Agents (narcotics)
Pharmacology of the musculoskeletal system
Roxanol (morphine), Demerol (meperidine), OxyContin (oxycodone), Sublimaze (fentanyl), Paveral (codeine)
Opioid Agents (narcotics)
Pharmacology of the musculoskeletal system
Used for treatment of opioid overdose and addiction
Opioid Antagonists
Pharmacology of the musculoskeletal system
Opioids — side effects:
- Common: Constipation, nausea and vomiting, sedation, pruritus
- Delirium less frequent
- Risk of respiratory depression
- Risk of abuse and diversion are important considerations
Pharmacology of the musculoskeletal system
the most common side effect of opioids agents
Constipation
due to opioids’ slowing peristalsis
Pharmacology of the musculoskeletal system
Opioids implications for PT:
A therapist must monitor the patient for potential side effects, especially signs of respiratory depression. Treatment that is otherwise painful should be scheduled approximately two hours after administration to maximize the analgesic benefit. A patient may not accurately report if a particular technique is painful.
Pharmacology of the musculoskeletal system
name a few classical 1st generation NSAIDs
Aspirin, Ibuprofen, Voltaren
Pharmacology of the musculoskeletal system
these agents provide analgesia and pain relief, produce anti-inflammatory effects, and initiate antipyretic (reduces fever) properties. These drugs promote a reduction of prostaglandin formation that decreases the inflammatory process, decreases uterine contractions, lowers fever, and minimizes impulse formation of pain fibers.
Nonopioid Agents
Pharmacology of the musculoskeletal system
Aspirin is for treatment of
Treatment of pain, inflammation, fever, vascular disorders
Pharmacology of the musculoskeletal system
Aspirin side effects:
GI problems, hepatotoxicity
Pharmacology of the musculoskeletal system
is acetaminophen (Tylenol) an anti-inflammatory agent?
no, most common analgesic/antipyretic
Pharmacology of the musculoskeletal system
Non-opioids agents implications for PT
- Patients are at increased risk for masked pain that would allow for movement beyond limitation or false understanding of their level of mobility.
- Complaints of stomach pain should be taken seriously with a subsequent referral to a physician.
Pharmacology of the musculoskeletal system
agents used to promote relaxation in muscles that typically present with spasm that is a continuous, tonic contraction. Spasms typically occur secondary to a musculoskeletal or peripheral nerve injury rather than CNS injury
Muscle Relaxant Agents
Pharmacology of the musculoskeletal system
Muscle Relaxant Agent side effects
(agent dependent) sedation, drowsiness, dizziness, nausea, vomiting, headache, tolerance, dependence
Pharmacology of the musculoskeletal system
Muscle relaxant agents implications for PT:
- Therapists must be aware of potential side effects, however, maximize the potential for relaxation through therapeutic techniques and the use of modalities during treatment.
- Prevention of re-injury through stretching, posture retraining, and education should assist the patient to achieve desired outcomes.
Pharmacology of the musculoskeletal system
Examples: Valium (diazepam), Flexeril (cyclobenzaprine), Paraflex (chlorzoxazone), Botulinum Toxin (Botox)
Muscle Relaxant Agents
Pharmacology of the musculoskeletal system
Used to treat conditions such as spasmodic torticollis, patients with spasticity, cerebral palsy, neuromuscular scoliosis, and other types of local dystonias. Injected directly into the muscles responsible for dystonia
Botulinum Toxin (Botox)
Prevents the release of Acetylcholine at the neuromuscular junction (chemical denervation)
Pharmacology of the musculoskeletal system
This muscle relaxant agent prevents the release of acetylcholine at the neuromuscular junction (chemical denervation)
Botox (Botulinum Toxin)
