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Pharmacology

Pharmacology for the PT

DrugUsesMechanism of ActionRehab Concerns
Acetaminophen Analgesic & antipyretic; NOT anti-inflammatory inhibits prostaglandins in CNS only gastroc irritation, renal and hepatic toxicity
Glucocorticosteroids Anti-inflammatory (systemic and in airways) inhibit prostaglandins catabolic effects, adrenocortical shock
Diuretics HTN and Congestive Heart Failure increase excretion of water depletion of electrolytes, orthostatic hypotension, weakness/fatigue
Beta-Blockers (-olol) HTN, arrhythmia, angina, heart failure, MI (decrease HR and force of contraction) Block effects of epinephrine & norepinephrine (adrenergic blocker) Bronchoconstriction, orthostatic hypotension, decrease exercise capacity
Vasodilators HTN & Heart failure cause vasodilation of vascular structures Postural hypotension, reflex tachycardia, dizziness, edema/fluid retention
ACE inhibitors (-pril) HTN & Heart failure decrease formation of AngII (which causes vasoconstriction), therefore causing vasodilation dry cough, dizziness, allergic reaction
Calcium Channel Blockers (-ipine) HTN, angina, arrythmia limit calcium entry into muscle; promote vasodilation peripheral edema, altered HR, orthostatic hypotension, risk of MI
Heparin Anticoagulant increase effects of antithrombin II Hemorrhage
Warfarin Anticoagulant inhibit vitamin K (which synthesizes klotting factors) Hemorrhage
Thrombolytics Used 3-6 hours post MI or 3 hours post ischemic stroke (NOT post hemorrhagic stroke) break down clot to restore blood flow Hemorrhage
Clotting Factor Replacement Clotting deficiencies (hemophilia) inhibit clot breakdown Increased clotting
Statins Hyperlipidemia inhibit enzymes that make cholesterol myalgia (rhabdomyalysis), nausea, liver toxicity, pancreatitis, arrhythmia, weakness, parasthesia
Fibric Acids Hyperlipidemia decrease triglycerides and increase VLDL myalgia (rhabdomyalysis), nausea, liver toxicity, pancreatitis, arrhythmia, weakness, parasthesia
Antitussives (Codine) Cough suppressants suppress cough reflex and cause anesthesia Sedation, GI upset, dependence, limit productive cough
Decongestants Sinus congestion Alpha-1 agonists (adrenergic agonists); vasoconstrict nasal mucosa Palpitations, headache, nausea, dependence, nervousness
Mucolytics Respiratory mucus; beneficial during P&PD break-up muco-bonds No major concerns
Expectorants Respiratory congestion; beneficial during P&PD increase ejection of phlegm No major concerns
Anti-histamines Allergies block effects of histamine Sedative, incoordination
Beta-adrenergic agonists Bronchodilation (Asthma); beneficial during P&PD stimulate beta-2 receptors and cause relaxation Bronchial irritation, cardiac stimulation, CNS stimulation
Xanthine Derivatives Bronchodilation (Asthma) mechanism unclear toxicity
Anti-cholinergic agents Asthma and Parkinson disease block acetylcholine to cause bronchodilation and reduce rigidity Dry mouth, tachycardia, constipation, confusion
Cromones Asthma and airway inflammation block histamine Unknown
Leukotriene modifiers Asthma and airway inflammation Leukotriene's are the prostaglandins of the airways Unknown
Polysynaptic inhibitors Muscle spasm decrease excitation of polysynaptic neurons...decrease alpha motor neuron activity in spinal cord Sedation
Diazepam (Valium) Muscle spasm and spasticity increase the inhibatory effects of GABA in brain and spinal cord Sedation, generalized weakness, drastic changes in muscle tone
Baclofen Spacticity Synthetic GABA Sedation, generalized weakness, drastic changes in muscle tone
Alpha-2 agonists Spacticity decrease excitation of alpha motor neuron Sedation, generalized weakness, drastic changes in muscle tone
Gabapentin Spacticity Synthetic GABA Sedation, generalized weakness, drastic changes in muscle tone
Botulinum toxin Spacticity muscle paralytic Sedation, generalized weakness, drastic changes in muscle tone
Levodopa (L-dopa) Parkinson disease crosses blood brain barrier to replce dopamine GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
Carbidopa Parkinson disease; with L-dopa inhibits L-dopa conversion into dopamine before crossing the blood brain barrier GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
COMT inhibitors Parikinson disease; with L-dopa inhibits breakdown of L-dopa before crossing the blood brain barrier GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
Dopamine agonists Parkinson disease synthetic dopamine GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
Amantadine Parkinson disease decrease influence of Aceytlcholine GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
Selegiline Parkinson disease inhibits MAO which breaks down dopine; therefore proloings the effect of dopamine GI distress, orthostatic hypotension, dyskinesias, psychotropic effects, chorea-like symptoms (increased dopamine)
Nitrates Angina cause vasodilation to decrease work of heart dizziness, headache, reflex tachycardia
Digoxin (Digitalis) Heart failure and arrhythmia slows electrial conduction & increase force of contraction arrhythmia, nausea, anorexia, mental status change, and hallucinations
Opioid (Narcotics) Analgesic alter pain perception at CNS (polysynaptic ot presynaptic) Sedation, tolerance, dependence, confusion, postural hypotension, respiratory depression
NSAIDS Analgesic, anti-inflammatory, antipyretic, anticoagulant inhibit prostaglandin synthesis gastric irritation, hepatic and renal toxicity
Created by: lkhaggitt on 2009-03-11



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