These are your patients:
These are your patients on drugs:
They look the same, don’t they? That’s because nearly all of your patients – young or old, athletes or critically ill – use some substance that changes their physiology. That substance may have been prescribed by another health care professional, but it might have been purchased over-the-counter, or it might be a relatively loosely regulated nutritional supplement. In any case, physiology changes in response to the presence of these molecules in the body. I’m sure most of you wouldn’t question the need for PTs to understand the implications of diabetes, multiple sclerosis, or asthma on patient/client management. Your examination of the patient, your choice of interventions, your evaluation of the patient’s response – any or all of these might be affected by a disease process. Well, it turns out that your management might be affected in the same way by drugs that patients are taking. Because they change physiology. Just like pathology.
I’m not implying that PTs should understand everything about every drug. We don’t prescribe, after all, at least not the vast majority of us. But I do believe there is some important overlap between pharmacology and function, and that is what I intend to write about here. My goals are to catch your interest, make you think about your practice and your clinical decision-making, generate some discussion, and to help you make the best decisions that you can for your patients.
I do not intend to drift off into a drug-bashing frenzy and certainly am not looking to “physician-bash”. There are many valuable medications that keep our patients alive and improve their function. But when it comes to drugs, we take the good with the bad, and need to be aware of what “the bad” might be. And physicians and other prescribers, along with PTs, are human and make mistakes. How we respond when we think a mistake has been made is the key. As another set of eyes and ears, we can listen to our patients and use our observation skills as advocates for patient safety when it comes to medications. So, I’ll try to keep you up to date as best I can when and where pharmacology intersects with function.
Check back in soon.
Photo by eskimo_jo, available under a Creative Commons Attribution-NonCommercial-NoDerivs license.