TY - CHAP M1 - Book, Section TI - Physical Agents A1 - Roy, Serge H. A1 - Wolf, Steven L. A1 - Scalzitti, David A. Y1 - 2013 N1 - T2 - The Rehabilitation Specialist's Handbook, 4e AB - Table Graphic Jump LocationTABLE 18.1Interactions Between Drugs and Commonly Used Physical ModalitiesView Table||Download (.pdf)TABLE 18.1Interactions Between Drugs and Commonly Used Physical ModalitiesModalityDesired Therapeutic EffectDrugs With Complementary/ Synergistic EffectsDrugs With Antagonistic EffectsOther Drug–Modality InteractionsCryotherapyCold/ice packs, ice massage, cold baths, vapocoolant spraysDecreased pain, edema, and inflammationMuscle relaxation and decreased spasticityAnti-inflammatory steroids (glucocorticoids); non-steroidal anti-inflammatory analgesics (aspirin and similar NSAIDs)Skeletal muscle relaxantsPeripheral vasodilators may exacerbate acute local edema.Nonselective cholinergic agonists may stimulate the neuromuscular junction.Some forms of cryotherapy may produce local vasoconstriction that temporarily impedes diffusion of drugs to the site of inflammation.ThermotherapyHot packsParaffinInfraredFluidotherapyDiathermyUltrasoundDecreased muscle/joint pain and stiffnessDecreased muscle spasmsIncreased blood flow to improve tissue healingNSAIDs; opioid analgesics; local anestheticsSkeletal muscle relaxantsPeripheral vasodilatorsNonselective cholinergic agonists may stimulate the neuromuscular junction.Systemic vasoconstric tors (e.g., α-1 agonists) may decrease perfusion of peripheral tissues. Systemic HeatLarge whirlpool Hubbard tankDecreased muscle/ joint stiffness in large areas of the bodyOpioid and nonopioid analgesics; skeletal muscle relaxants Severe hypotension may occur if systemic hot whirlpool is administered to patients taking peripheral vasodilators and some antihypertensive drugs (e.g., α-1 antagonists, nitrates, direct-acting vasodilators, calcium channel blockers).Ultraviolet radiationIncreased wound healingManagement of skin disorders (acne, rashes)Various systemic and topical antibioticsSystemic and topical antibiotics and anti-inflammatory steroids (glucocorticoids)Many drugs may cause hypersensitivity reactions that result in skin rashes, itching.Antibacterial drugs generally increase cutaneous sensitivity to ultraviolet light (i.e., photosensitivity).Photosensitivity with antibacterial drugs.Transcutaneous electrical nerve stimulation (TENS)Decreased painOpioid and nonopioid analgesicsOpioid antagonists (naloxone). Functional electrical stimulation (FES)Increased skeletal muscle strength and enduranceDecreased spasticity and muscle spasmsSkeletal muscle relaxantsSkeletal muscle relaxants.Nonselective cholinergic agonists may stimulate the neuromuscular junction. From Ciccone, CD: Pharmacology in Rehabilitation, ed. 3. FA Davis, Philadelphia, 1996, inside front cover, with permission. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - fadavispt.mhmedical.com/content.aspx?aid=1133438252 ER -