Hey guys, welcome to PT Snacks podcast. This is Kasey, your host, and if you are tuning in for the very first time, first of all, welcome. But what you need to know is that this podcast has meant for physical therapists and physical therapists, students who are looking to grow your fundamentals in bici segments of time. And today, before we get into our topic, where we're gonna be talking about what we need to know about hypertension and cholesterol drugs in a PT clinic. If you have listened to three or more episodes of PT snacks or you're really benefiting from it, if you wouldn't mind pausing this episode and leaving a review, whether it's a written review or you're just hitting the stars, that would mean the world to me. And if you've already left a review, thank you so much. Those really mean a lot to me. And really help the show out a lot. But now that we've said that let's dive in today's topic. And I know if you're like me, maybe pharmacology is not a topic that you enjoy the most, but it is one that is super important. And while if you, when you were in PT school, when you were in pharmacology, you may have had all of the different medications memorized, like you could say in your sleep. It's easy to lose touch of that after a few years out of the clinic. Still, even though these aren't the most exciting topics, I really think it is important to have at the forefront of your brain, which is why I'm choosing to cover it today. So we, today's episode is all about what we all see in a lot of outpatient orthopedic settings. Our patients on medications for high blood pressure and high cholesterol. Now. The meds are super common, but they can affect how your patients respond to exercise. So we're just gonna break down the most common ones, how they might affect a session and some red flags to look out for. And this episode, just keep in mind, this is for educational purposes only. You always should consult the medical team, especially if you notice changes in how your patient is responding during treatment. Just have to put that disclaimer in there. But we're gonna start off with talking about blood pressure medicines and a few classes that we see a lot. So first beta blockers. So examples can be meta prolo or olol. Ones that end in low, not laugh out loud. These often how they work are to slow down the heart rate and reduce blood pressure. So what this means for us as their physical therapist is their heart rate response is gonna be a little blunted. So you can't rely on heart rate, if that's normally what you do to monitor exercise intensity, you'll probably instead wanna use the RPE scale which stands for rate of perceived exertion. So this is basically where you ask your patient to rate how hard the exercise is versus using, again, their blood pressure. You also wanna watch out for fatigue, dizziness and if they are diabetic as well. Beta blockers can also mask signs of hypoglycemia like shakiness or tachycardia. So definitely keep be on the lookout when you're looking at your patient's medicine list and see if you recognize any of those. Another class is ACE inhibitors and ARBs. So examples would be like lisinopril, or losartan. You guys get to listen to me pronounce all these is awesome. These lower your blood pressure by relaxing the blood vessels. So they generally don't affect the heart rate too much, but they can lead to orthostatic hypotension, especially if it's in an older adult. ACE inhibitors can also cause a dry cough and in rare cases, angioedema. Next class calcium channel blockers. So examples of these aMLO Dipping or d. Some work on the heart, others on the blood vessels. The main issue that we see is peripheral edema, especially in the lower legs, so they can also contribute to orthostatic hypotension and then diuretics like hydrochlorothiazide or ide, these can help the body get rid of extra fluid. So it's great for blood pressure control, but the flip side is electrolyte imbalance and dehydration, and this can lead to cramps, dizziness, and for some even ath arrhythmia arrhythmias. Now switching gears a little bit into cholesterol medications. These are lipid lowering medicines, especially statins. So statins like a Atorvastatin or simvastatin. These are used to help reduce cholesterol and lower cardiovascular risk, but the most common PT related side effect can be muscle pain or weakness as particularly in the proximal muscles like the hips or shoulders. If a patient starts reporting unusual soreness or a weakness that wasn't there before, or it's not resolving with rest, it's worth flagging. In rare cases, statins can cause rhabdomyolysis, which is muscle breakdown that leads to dark urine and potential kidney damage. This is. Not something that you miss around with. Definitely important to note. And then other lipid meds, like fibrates and niacin are less common, but if you see them, the main concern is still muscle effects or GI upset. What should we look out for? Some red flags that should make you stop treatment or modify treatment would be dizziness that doesn't resolve with rest, unusual or sudden fatigue, chest pain, palpitations, or shortness of breath, sudden leg swelling or severe cramping and heart rate or blood pressure responses that don't make sense with what activity that they're doing. Some ways that we can be ahead of the game in our PT clinic or wherever you're treating really. We can ask about medication changes regularly. We can use RPE and patients on heart rate, blunting, medicines medications. We can educate patients on hydration and reporting muscle pain that's different than DOMS and collaborate with their healthcare team. If anything just seems off. So there you have it. That's the crash course on the most common blood pressure in cholesterol medicines that you'll see in outpatient pt. It's just, it can be so helpful for us as providers to make sure that we are managing the patient as a whole in front of us because they are not just a patient who has maybe knee pain or shoulder pain, but they are a, their body is a very complex, incredible system that interacts with. Multiple systems within itself. If you want more resources on this cone, I don't know if I'm pronouncing that but there's, pharmacology and rehabilitation is a resource You can check out ACMs guidelines for exercise testing and prescription. Also has some resources. drugs.com or Medscape Drug Interaction Checker can be helpful if you just wanna look up specific drugs that are on your patients charts. Then also med Bridge has a couple courses too as well that could be helpful if you wanna take a deeper dive. So if you don't know what Med Bridge is, it's basically this huge online company that has thousands of courses that have CCU courses that you can listen to on your own time. They have webinars, they have specialty prep exam courses. I definitely used it for my OCS. But they have specific courses. One is by Kenneth L. Miller called Exercise and Drug Interactions. So good deep dive or. Basically physiologically drug metabolism and exercise prescription. And then Andrew Oppe has a course called Pharmacology for Rehabilitation Considerations for the Aging Adults. So talks more about exploring the effect of drugs like anti-hypertensives and statins especially in older adults. So if you're interested and don't have med Bridge is actually a sponsor of this. Podcast and they're offering listeners over a hundred dollars off their annual subscription. And students, you get an even better discount. So if you would like to use those discount codes, they're down in the show notes below. But other than that, if you have any questions, please let me know. And that's it for today, guys. Until next time.