Pharma Effects on Specific Systems

Question 1

General Anesthesia

Answer 1

• Confusion + muscle weakness = most common
• Can last for several days
• Can result in retained pulmonary secretions = postural drainage + breathing techniques

Question 2

Local Anesthesia

Answer 2

• Diminished sensation + motor function

- Do NOT put heating modalities on/near transdermal patch -> accelerates absorption = toxic effects

Question 3

Opioid Analgesic Agents

Answer 3

• Sedation + respiratory depression
• Schedule PT to coincide with max effectiveness of drug to allow PT to be more aggressive + better participation from pt

Question 4

Nonsteroidal Anti-Inflammatory Agents

Answer 4

• GI discomfort — UNLIKELY to have effect on PT session

- Not as strong as opioids but also don’t cause sedation

Question 5

Antiarthritic Agents

Answer 5

• Depends on type of agent
• Glucocorticoid drugs = breakdown of tendon, bone or skin —— CAUTIOUS with aggressive stretching + strengthening exercises to decrease risk of FRACTURE and SOFT TISSUE INJURY
• Some can cause joint pain + swelling

Question 6

Antiepileptic Agents

Answer 6

• Cerebellar side effects - ataxia, loss of coordination

- Skin conditions - dermatitis

Question 7

Skeletal Muscle Relaxants

Answer 7

• Sedation + muscle weakness

Question 8

Anti-Parkinson’s Agents

Answer 8

• Orthostatic hypotension

- Schedule PT to coincide with max effectiveness - 1 hour after administration with Levodopa

Question 9

Antihypertensive Agents

Answer 9

• Orthostatic hypotension
• Avoid interventions that cause widespread VASODILATION - ex: whirlpool
• Use RPE if they have diminished HR response to exercise (Beta blockers)

Question 10

Antianginal Agents

Answer 10

• Orthostatic hypotension
• Avoid interventions that cause widespread VASODILATION - ex: whirlpool
• Use RPE
• Some pts may have increased exercise tolerance because they are not limited by angina

Question 11

Antiarrhythmic Agents

Answer 11

• Can cause increase in arrhythmias or change in type of arrhythmia
• If using Beta blockers or calcium channel blockers = OH

Question 12

CHF Agents

Answer 12

• Depends on type of drug
• Diuretics = fatigue + muscle weakness associated with diminished fluid + electrolyte levels
• Vasodilating drugs = OH = avoid interventions that cause widespread vasodilation = whirlpool

Question 13

Anticoagulant Agents

Answer 13

• Increased risk of bleeding

- Interventions that can cause tissue trauma (soft tissue massage, chest percussion, etc) performed with CAUTION

Question 14

Respiratory Agents

Answer 14

• Bronchodilators - cardiac arrhythmias, confusion, + tremors = signs of toxicity = closely monitor
• Mucolytic + expectorant agents - no significant side effects - NEED to be taken 30-60 min before chest PT for max effectiveness

Question 15

Sedative-hypnotic + Antianxiety Agents

Answer 15

• Drowsiness, increased risk of falls + injury

- AVOID scheduling PT a few hours after taking because pt is too drowsy to actively participate

Question 16

Antidepressant Agents

Answer 16

• Depends on type
• Lithium + tricyclics = sedation + muscle weakness
• Some cause and increased risk for OH while others cause increased risk for HTN

Question 17

Antipsychotic Agents

Answer 17

• Extrapyramidal sx = dyskinesia + dystonia

- Monitor for changes in posture, balance, + movement pattern + NOTIFY personnel IMMEDIATELY

Question 18

GI Agents

Answer 18

• Side effects do not interrupt PT

- Minor side effects = dizziness, fatigue, + GI disturbances

Question 19

Adrenocorticosteroid Agents

Answer 19

• Glucocorticoid drugs = breakdown of tendon, bone or skin —— CAUTIOUS with aggressive stretching + strengthening exercises to decrease risk of FRACTURE and SOFT TISSUE INJURY
• Most effect on older, inactive pts with poor nutrition habits
• Glucocorticoid + mineralocorticoid drugs can lead to water retention + contribute to HTN - MONITOR BP

Question 20

Sex Hormone Replacement Therapy

Answer 20

• Estrogen, progesterones, + androgens = salt + water retention = HTN - MONITOR BP

Question 21

Thyroid Agents

Answer 21

• Side effects associated with sx of the opposite condition
• Parathyroid - calcium supplementation -> cardiac arrhythmias if used in excessive amounts - PT monitor cardiac function to avoid drug toxicity

Question 22

Insulin Replacement Therapy

Answer 22

• Hypoglycemia - (see notecard for sx)

- Monitor + provide source of glucose if needed

Question 23

Antibacterial Agents

Answer 23

• Hypersensitivity of skin or respiratory tract

- CAUTION with use of UV light treatment

Question 24

Chemotherapy Agents

Answer 24

• Severe fatigue - will be days when pt cannot tolerate even a light workload
• Toxic effects of CNS + PNS - AWARE of peripheral neuropathy or ataxia

Question 25

Immunomodulating Agents

Answer 25

- Catabolic effects on muscle, tendon + bone - CAUTIOUS with aggressive stretching + strengthening exercises to decrease risk of FRACTURE and SOFT TISSUE INJURY - Balance + gait impairments 2* peripheral neuropathy or CNS damage