Anterior Apprehension Test
Assessment for Anterior glenohumeral instability
Posterior Apprehension Test
Assessment for posterior glenohumeral instability
Cross Flexion test
Assessment for acromioclavicular joint injury
What should be assessed before/after applying a sling?
P - Pulse, cap refill
M - Motor function
S - Sensation
Absorption
Routes of administration
Factors affecting absorption
Drug factors (formation, particle size, etc)
Host factors (motility of gut, food in stomach, V/D)
Bioavailability (how much is utilized)
What is the first-pass effect?
Decrease in the active drug’s concentration upon reaching systemic circulation or its site of action.
How are drugs distributed in the body?
Plasma
Interstitial fluid
Intracellular fluid
Transcellular fluids (CSF, peritoneal, pleural)
Fat
Factors affecting distribution
Mechanical (blood flow, barriers [BBB, placenta])
Biochemical (lipid solubility, binding to plasma proteins, pH)
What are the biotransformations that drugs can undergo?
Activated (prodrug to drug)
Changed to another active metabolite
Changed to a toxic metabolite
Inactivated
What is metabolism of drugs?
Biotransformation of drugs
- conversion by enzyme
- occurs in SER in liver
– also kidneys, GI, plasma
What are the 2 phases of metabolism?
Phase I - conversion to polar metabolite (oxidation, reduction, hydrolysis)
Phase II - conjugation, coupling of drug (or its polar metabolite) with an endogenous substance
What factors affect metabolism?
Genes
Environmental (drug interactions)
Physiological (age, liver disease, renal disease, etc)
Where are drugs eliminated?
Kidneys
GI tract
Exhalation
Saliva
