TY  - CHAP
M1  - Book, Section
TI  - Antiarrhythmic Drugs
A1  - Jobst, Erin E.
A1  - Panus, Peter C.
A1  - Kruidering-Hall, Marieke
PY  - 2020
T2  - Pharmacology for the Physical Therapist, 2e
AB  - CASE  STUDYS.M.  is  a  42-year-old  woman  with  a  history  of  paroxysmal  atrial  fibrillation  and  mitral  valve  prolapse  since  childhood.  The  patient  is  under  the  care  of  a  cardiologist  for  these  conditions.  She  has  a  body  mass  index  of  25  kg/m2  and  no  other  documented  comorbidities.  Her  job  requires  her  to  examine  carbon  fiber  aerospace  components  at  the  end  of  the  manufacturing  process.  The  required  physical  motions  include  stacking  objects  weighing  8-15  lb  and  bending  over  repetitively  during  an  8-hour  shift.  Three  weeks  ago,  S.M.  felt  a  sudden  and  extreme  pain  in  the  right  lumbar  area  while  bending  over  to  retrieve  a  component  that  had  fallen  on  the  floor.  She  was  transported  to  the  emergency  department  and  discharged  with  a  prescription  for  meloxicam,  a  nonsteroidal  anti-inflammatory  drug.  The  patient  was  seen  by  the  corporate  physician  2  days  later  and  referred  to  an  outpatient  physical  therapy  clinic  for  pain  relief  and  a  return-to-work  program.  At  the  first  appointment,  the  therapist  noted  that  S.M.  needed  assistance  getting  out  of  the  vehicle  passenger  seat.  Beyond  activities  of  daily  living  and  clinic  visits,  S.M.  states  that  she  has  done  almost  no  physical  activity.  She  has  remained  in  bed  or  on  the  couch.  Her  current  medications  include  diltiazem  and  naproxen,  an  over-the-counter  nonsteroidal  anti-inflammatory  drug  that  she  started  taking  after  she  completed  her  prescription  of  meloxicam.  The  first  three  sessions  of  therapy  were  aimed  at  minimizing  pain  and  improving  functional  mobility.  Today,  S.M.  arrives  to  begin  the  functional  return-to-work  program.  At  rest,  her  heart  rate  is  78  bpm,  regular  rhythm  and  her  blood  pressure  is  132/89  mm  Hg.  Fifteen  minutes  into  the  return-to-work  exercises,  the  patient  complains  of  chest  palpitations  that  she  recognizes  as  an  arrhythmia.  Determination  of  vital  signs  indicates  her  heart  rate  is  120  bpm,  irregular  rhythm  and  blood  pressure  is  159/98  mm  Hg.  After  several  minutes,  her  palpitations  recede  and  heart  rate  becomes  regular  though  still  tachycardic  at  102  bpm.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accessphysiotherapy.mhmedical.com/content.aspx?aid=1192814505
ER  -