RT Book, Section
A1 Jobst, Erin E.
A1 Panus, Peter C.
A1 Kruidering-Hall, Marieke
SR Print(0)
ID 1192816785
T1 Drugs of Abuse
T2 Pharmacology for the Physical Therapist, 2e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781259862229
LK accessphysiotherapy.mhmedical.com/content.aspx?aid=1192816785
RD 2024/04/19
AB CASE  STUDYK.C.  is  a  54-year-old  employee  at  an  automotive  assembly  plant.  Three  weeks  ago  on  the  assembly  line,  he  was  rotating  and  bending  when  he  felt  a  sudden  pain  in  the  left  side  of  his  low  back.  He  was  immediately  taken  to  the  emergency  department,  given  a  diagnosis  of  musculoskeletal  strain,  and  provided  Tylenol  with  codeine  #3  (codeine  and  acetaminophen)  with  instructions  to  take  on  an  as-needed  basis  for  pain  relief.  K.C.  was  scheduled  for  evaluation  and  enrollment  in  a  work-hardening  program  prior  to  return  to  full-time  employment  at  the  plant.  Last  week,  K.C.  was  evaluated  at  the  rehabilitation  clinic.  Relevant  history  during  the  initial  assessment  included  intermittent  exertional  angina  and  an  approximate  15  pack-year  smoking  history  (half  pack  of  cigarettes  per  day  for  30  years).  In  addition  to  a  daily  baby  aspirin,  K.C.  has  been  taking  Tylenol  #3  every  day  since  his  injury.  For  his  first  work-hardening  therapy  session,  K.C.  arrived  for  an  early  morning  appointment.  He  admitted  that  he  rushed  to  the  clinic  having  only  eaten  a  breakfast  of  “coffee  and  a  couple  of  cigarettes”  with  Tylenol  #3  about  an  hour  ago.  The  clinic’s  work-hardening  program  includes  a  set  of  progressive  aerobic  activities  designed  to  mimic  the  employees’  activities  at  the  plant  in  order  to  improve  biomechanical  function  and  reduce  the  incidence  of  workplace  injuries.  Within  about  10  minutes  of  starting  the  session,  K.C.  complains  of  shortness  of  breath  and  pain  along  his  left  arm.  The  physical  therapist  instructs  him  to  rest  and  measures  his  blood  pressure  and  heart  rate  at  155/92  mm  Hg  and  99  bpm  (with  regular  rhythm),  respectively.  The  therapist  continues  monitoring  the  patient’s  vital  signs  and  symptoms.  Over  the  next  20  minutes,  K.C.’s  angina  and  dyspnea  dissipate  and  blood  pressure  and  heart  rate  decrease  to  131/84  mm  Hg  and  83  bpm,  respectively.