Pharmacology in Rehabilitation 4th ed - C. Ciccone (F.A. Davis, 2007) WW.pdf - książki - Bio Med 19 - bibiariel

Potential Interactions between Physical Agents and Therapeutic Drugs

Listed here are some potential interactions between physical agents used in rehabilitation and various pharma-

cologic agents. It is impossible to list all the possible relationships between the vast array of therapeutic drugs

and the interventions used in physical therapy and occupational therapy. However, some of the more common

interactions are identified here.

Desired

Drugs with

Other Drug-

Therapeutic

Complementary/

Antagonistic

Modality

Effect

Synergistic Effects Effects

Interactions

Cryotherapy

Cold/ice packs

Ice massage

Cold bath

Vapocoolant sprays

Decreased pain, edema,

and inflammation

Anti-inflammatory steroids

(glucocorticoids); non-

steroidal anti-inflamma-

tory analgesics (aspirin

and similar NSAIDs)

Skeletal muscle relaxants

Peripheral vasodilators

may exacerbate acute

local edema

Some forms of cryotherapy

may produce local vaso-

constriction that temporarily

impedes diffusion of drugs

to the site of inflammation

Muscle relaxation and

decreased spasticity

Nonselective cholinergic ago-

nists may stimulate the

neuromuscular junction

—

Superficial and

deep heat

Local application

Hot packs

Paraffin

Infrared

Fluidotherapy

Diathermy

Ultrasound

Decreased muscle/joint

pain and stiffness

Decreased muscle spasms

NSAIDs; opioid analgesics;

local anesthetics

Skeletal muscle relaxants

—

Nonselective cholinergic ago-

nists may stimulate the

neuromuscular junction

Systemic vasoconstrictors

(e.g., alpha-1 agonists)

may decrease perfusion

of peripheral tissues

—

Increased blood flow

to improve tissue

healing

Peripheral vasodilators

—

Systemic heat

Large whirlpool

Hubbard tank

Decreased muscle/joint

stiffness in large areas

of the body

Opioid and nonopioid anal-

gesics; skeletal muscle

relaxants

—

Severe hypotension may occur

if systemic hot whirlpool is

administered to patients

taking peripheral vasodila-

tors and some antihyper-

tensive drugs (e.g., alpha-1

antagonists, nitrates, direct-

acting vasodilators, calcium

channel blockers)

Ultraviolet radiation

Increased wound healing

Various systemic and

topical antibiotics

—

Antibacterial drugs generally

increase cutaneous sensi-

tivity to ultraviolet light (i.e.,

photosensitivity)

Photosensitivity with antibac-

terial drugs

Management of skin disor-

ders (acne, rashes)

Systemic and topical

antibiotics and anti-

inflammatory steroids

(glucocorticoids)

Many drugs may cause

hypersensitivity reactions

that result in skin rashes,

itching

Transcutaneous electrical

nerve stimulation (TENS)

Decreased pain

Opioid and nonopioid

analgesics

Opioid antagonists

(naloxone)

—

Functional neuromuscular

electrical stimulation

Increased skeletal muscle

strength and endurance

Decreased spasticity and

muscle spasms

—

Skeletal muscle relaxants

—

Skeletal muscle relaxants

Nonselective cholinergic ago-

nists may stimulate the

neuromuscular junction

—

Common Drug Suffixes

Medications that are chemically and functionally similar often have generic names that share a common ending

or suffix. Listed here are some drug classes that contain groups of drugs that share a common suffix. Please note

that some members of a drug class may have a suffix that is different from the one indicated; for instance, not all

benzodiazepines end with “-epam” or “-olam.”

Primary Indication or

Desired Effect (Chapter

Drug Class

Suffix

Common Examples

in Parentheses)

Angiotensin-converting

enzyme (ACE) inhibitors

-pril

Captopril, enalapril

Antihypertensive (21), congestive

heart failure (24)

Azole antifungals

-azole

Fluconazole, miconazole

Fungal infections (35)

Barbiturates

-barbital

Phenobarbital, secobarbital

Sedative-hypnotic (6), antiseizure (9),

anesthetic (11)

Benzodiazepines

-epam or -olam

Diazepam, temazepam, alprazolam,

triazolam

Sedative-hypnotic (6), antianxiety (6),

antiseizure (9), anesthetic (11)

Beta blockers

-olol

Metoprolol, propranolol

Antihypertensive (21), antianginal

(22), antiarrhythmic (23), conges-

tive heart failure (24)

Bisphosphonates

-dronate

Alendronate, pamidronate

Osteoporosis (31)

Bronchodilators (adrenergic)

-erol

Albuterol, pirbuterol

Bronchodilation (26)

Bronchodilators (xanthine derivatives)

-phylline

Theophylline, aminophylline

Bronchodilation (26)

Calcium channel blockers

(dihydropyridine group)

-ipine

Nifedipine, nicardipine

Antihypertensive (21),

antianginal (22)

Cyclooxygenase type 2

(COX-2) inhibitors

-coxib

Celecoxib

Pain, inflammation (15)

Glucocorticoids

-sone or -olone *

Cortisone, dexamethasone, prednis-

one, prednisolone, triamcinolone

Anti-inflammatory (16, 29), immuno-

suppressants (37)

Histamine H 2 -receptor blockers

-idine

Cimetidine, ranitidine

Gastric ulcers (27)

HIV protease inhibitors

-avir

Ritonavir, saquinavir

HIV infection (34)

HMG-CoA reductase inhibitors (statins)

-statin

Pravastatin, simvastatin

Hyperlipidemia (25)

Local anesthetics

-caine

Lidocaine, bupivicaine

Local anesthetic (12),

antiarrhythmics (23)

Low molecular-weight heparins

-parin

Dalteparin, enoxaparin

Anticoagulants (25)

Oral antidiabetics

(sulfonylurea group)

-amide

Chlorpropamide, tolbutamide

Antidiabetic (type II diabetes melli-

tus) (32)

Penicillin antibiotics

-cillin

Penicillin, ampicillin, amoxicillin

Bacterial infections (33)

Proton pump inhibitors

-prazole

Omeprazole, lansoprazole

Gastric ulcers (27)

Tetracycline antibiotics

-cycline

Tetracycline, doxycycline

Bacterial infections (33)

Various other antibacterials

-micin or -mycin †

Streptomycin, gentamicin,

erythromycin

Bacterial infections (33)

*Some anabolic steroids also end with -olone, e.g., nandrolone, oxymetholone (Chapter 30).

†Some antibiotics ending with “-mycin” or “rubicin” are used as antineoplastics (Chapter 36).

Pharmacology in

Rehabilitation

4th Edition

Contemporary Perspectives in Rehabilitation

Steven L. Wolf, PT, PhD, FAPTA, Editor-in-Chief

Pharmacology in Rehabilitation, 4th Edition

Charles D. Ciccone, PT, PhD

Vestibular Rehabilitation, 3rd Edition

Susan J. Herdman , PT, PhD, FAPTA

Modalities for Therapeutic Intervention, 4th Edition

Susan L. Michlovitz , PT, PhD, CHT and Thomas P. Nolan, Jr. , PT, MS, OCS

Fundamentals of Musculoskeletal Imaging, 2nd Edition

Lynn N. McKinnis , PT, OCS

Wound Healing: Alternatives in Management, 3rd Edition

Luther C. Kloth , PT, MS, CWS, FAPTA, and

Joseph M. McCulloch , PT, PhD, CWS, FAPTA

Evaluation and Treatment of the Shoulder:

An Integration of the Guide to Physical Therapist Practice

Brian J. Tovin , PT, MMSc, SCS, ATC, FAAOMPT and

Bruce H. Greenfield , PT, MMSc, OCS

Cardiopulmonary Rehabilitation: Basic Theory and Application, 3rd Edition

Frances J. Brannon , PhD, Margaret W. Foley , RN, MN,

Julie Ann Starr , PT, MS, CCS, and Lauren M. Saul , MSN, CCRN

For more information on each title in the Contemporary Perspectives in Rehabilitation

series, go to www.fadavis.com.

Pharmacology in Rehabilitation 4th ed - C. Ciccone (F.A. Davis, 2007) WW.pdf

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