Novo-Pindol, Syn-Pindolol, Visken
Pharmacologic: beta blockers
Management of hypertension. Unlabeled Use: Management of angina pectoris.
Blocks stimulation of beta1 (myocardial) and beta2 (pulmonary, vascular, and uterine)–adrenergic receptor sites. Has intrinsic sympathomimetic activity (ISA), which may produce less bradycardia. Therapeutic Effects: ↓ heart rate and blood pressure.
Adverse Reactions/Side Effects
CNS: fatigue, weakness, anxiety, depression, dizziness, drowsiness, insomnia, memory loss, mental status changes, nervousness, nightmares. EENT: blurred vision, dry eyes, nasal stuffiness. Resp: bronchospasm, wheezing. CV: ARRHYTHMIAS, BRADYCARDIA, CHF, PULMONARY EDEMA, orthostatic hypotension, peripheral vasoconstriction. GI: constipation, diarrhea, nausea. GU: erectile dysfunction, decreased libido. Derm: itching, rashes. Endo: hyperglycemia, hypoglycemia. MS: arthralgia, back pain, muscle cramps. Neuro: paresthesia. Misc: drug-induced lupus syndrome.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Assess heart rate, ECG, and heart sounds, especially during exercise (See Appendices G, H). Report immediately an unusually slow heart rate (bradycardia) or signs of other arrhythmias, including palpitations, chest discomfort, shortness of breath, fainting, and fatigue/weakness.
Assess routinely for signs of CHF and pulmonary edema, including dyspnea, rales/crackles, weight gain, peripheral edema, and jugular venous distention. Report these signs to the physician immediately.
Assess blood pressure (BP) periodically and compare to normal values (See Appendix F) to help document antihypertensive effects.
Assess BPe when patient assumes a more upright position (lying to standing, sitting to standing, lying to sitting). Document orthostatic hypotension and contact physician when systolic BP falls >20 mm Hg, or diastolic BP falls >10 mm Hg.
Assess exercise tolerance and episodes of angina pectoris. Document improvements in these variables, but also report any decline in exercise tolerance or increased frequency/severity of anginal attacks.
Assess symptoms of bronchospasm (wheezing, coughing, tightness in chest). Perform pulmonary function tests to quantify suspected changes in ventilation and respiration (See Appendices I, J, K). Repeated or prolonged bronchoconstriction may require a change in dose or medication (e.g., switch to a more cardioselective beta blocker).
Monitor signs of peripheral vasoconstriction, such as extreme coldness in the hands and feet, cyanosis, and muscle cramping. Notify physician of severe or prolonged signs of vasoconstriction.
Assess any back pain, joint pain, or muscle cramps to rule out musculoskeletal pathology; that is, try to determine if pain is drug induced rather than caused by anatomic or biomechanical problems.
Assess signs of paresthesia (numbness, tingling), and perform objective tests, including
electroneuromyography and sensory testing to document any drug-related neuropathic changes.
Monitor mood and personality changes, including depression, anxiety, memory loss, or other changes in behavior. Notify physician if these changes become problematic.
Assess dizziness and drowsiness that might affect gait, balance, and other functional activities (See Appendix C). Report balance problems and functional limitations to the physician, and caution the ...