Course Title: Pharmacology in Rehabilitation

Instructor: Charles Ciccone, PT, PhD, FAPTA

ciccone@ithaca.edu

I. BROAD PURPOSE OF COURSE

This course in 14 hours of recorded lectures will present the primary drug classes and the physiologic basis of
their action. Drugs will be grouped according to their general effects and the type of disorders they are
routinely used to treat. Special emphasis will be placed on drugs that are commonly used to treat people
receiving physical therapy. This course will likewise address how drug therapy interacts with physical therapy,
and how drugs can exert beneficial effects as well as adverse side effects that impact on rehabilitation.

II. COURSE OBJECTIVES

Upon successful completion of this course, the student will be able to:

1. Integrate pharmacokinetic principles with pharmacodynamics, and judge how drug effects are influenced
by their administration, absorption, distribution, storage, and metabolism in the human body.
2. Compare and contrast general categories of drugs that are used therapeutically to treat specific problems
in the body.
3. Compare and contrast the physiological mechanisms by which individual drugs affect the different organ
systems in the body.
4. Evaluate drug side effects, and differentiate these side effects from the symptoms of the patient’s
disease(s).
5. Assess situations where drug levels are too high versus too low (i.e., increased drug toxicity versus
decreased efficacy).
6. Judge the potential for harmful interactions between specific drugs and various physical therapy
interventions.
7. Choose physical therapy interventions in accordance with the patient’s drug regimen.

III. TEACHING METHODS

Students will have access to online slides and voice over by the instructors similar to a lecture presentation.
Readings are required and connection to the web allows for students to access relevant abstracts/articles and
other materials. There will be relevant articles and other pertinent documents. A “discussion board” and email
will allow student and faculty interaction.

IV. GRADING POLICY

One final exam will be available to take throughout the semester. The exam is open note and open book.
Written examination including multiple choice and true/false. These items are based on lecture material
provided in the course, information in the required textbook readings and the student’s ability to search for,
obtain and critically analyze the relevant literature. There will be a cumulative four (4) hours to take the exam.

GRADING

The grading criteria will follow the policy of the School of Physical Therapy and Rehabilitation Science (see
student handbook) with a passing grade being a “C”. All students must practice academic honesty. Academic
misconduct is subject to an academic penalty by the course instructor and /or disciplinary sanction by the
University. Any evidence of cheating or plagiarism will result in failure of the course. All students need to be
familiar with the Student Conduct Code

V. CLASS SCHEDULE

Distance education therefore no regular meeting times. Lecture outline is as follows:

Section Title Chapter Time

Part 1 Basic Principles of Pharmacology Chapters 1-3 52:57 minutes
Part 2 Segment 1 Pain and Inflammation: opioids, PCA Chapters 14,17 31:02 minutes
Pain and Inflammation: NSAID’s;
Part 2 Segment 2 Chapters 15, 29 50:21 minutes
acetaminophen; glucocorticoids
Part 3 Muscle Relaxants Chapter 13 47:38 minutes
Part 4 Anesthesia Chapters 11, 12 45:45 minutes
Part 5 Seizure Disorders Chapter 9 23:49 minutes
Part 6 Parkinson Disease Chapter 10 41:26 minutes

Psychopharmacology: sedative-hypnotics;
Part 7 Segment 1 Chapters 6, 7 46:59 minutes
antianxiety drugs; antidepressants

Psychopharmacology: antipsychotics; treatment

Part 7 Segment 2 Chapter 8 28:02 minutes
of dementia
Cardiovascular Drugs: drugs affecting blood
Part 8 Segment 1 Chapters 21 - 24 58:08 minutes
pressure, heart failure, angina
Cardiovascular Drugs: coagulation disorders,
Part 8 Segment 2 Chapter 25 50:00 minutes
treatment of hyperlipidemia

Respiratory Drugs: antitussives; antihistamines;

Part 9 Segment 1 Chapter 26 43:16 minutes
decongestants; bronchodilators

Respiratory Drugs: Treatment of airway

Chapter 26; supplemental
Part 9 Segment 2 inflammation; supplemental O2; surfactant; 27:48 minutes
reading “A” (see below)
nitric oxide; drugs to quit smoking

Gastrointestinal Drugs: Antacids; antidiarrheals;

Part 10 Chapter 27 19:03 minutes
laxatives

Part 11 Segment 1 Treatment of Infection: antibacterials; antivirals Chapters 33, 34 36:29 minutes

Treatment of Infection: Anti-HIV drugs;

Part 11 Segment 2 Chapters 34, 35 27:27 minutes
antifungals
Part 12 Cancer Chemotherapy Chapter 36 33:41 minutes
Endocrine Pharmacology: treatment of diabetes
Part 13 Segment 1 Chapter 32 40:53 minutes
mellitus
 Endocrine Pharmacology: male and female
Part 13 Segment 2 Chapters 30, 31 46:05 minutes
hormones; thyroid hormones
Part 14 Arthritis Chapter 16 26:36 minutes
Part 15 Complimentary & Alternative Medicines Chapter 38 31:43 minutes
Supplemental reading “B”
Part 16 Geriatric Pharmacology 27:27 minutes
(see below)
Total Time = 836:35 minutes
* Readings refer to Ciccone: Pharmacology in Rehabilitation, 5th edition, unless otherwise indicated. If you are interested, other supplemental or optional
references are:

A: Ciccone CD: Medications. In: DeTurk W, Cahalin L (eds): Cardiopulmonary Physical

Therapy, ed 2. McGraw-Hill, NY, 2011.

B: Ciccone CD. Geriatric pharmacology. In: Guccione AA, Wong R, Avers D (eds.): Geriatric Physical Therapy, ed 3. CV Mosby, St Louis, 2012.

VI. REQUIRED TEXTS

Ciccone, CD: Pharmacology in Rehabilitation, edition 5. F.A. Davis, Company, Philadelphia, 2016

VII. SUGGESTED READINGS

o Ciccone CD: Medications. In: DeTurk W, Cahalin L (eds): Cardiopulmonary Physical Therapy,
ed 2. McGraw-Hill, NY, 2011.
o Ciccone CD. Geriatric pharmacology. In: Guccione AA, Wong R, Avers D (eds.): Geriatric
Physical Therapy, ed 3. CV Mosby, St Louis, 2012.

VIII. Recommended Resources

• Afiadata A, Ellsworth P. Testosterone replacement therapy: who to evaluate, what to use, how to follow,
and who is at risk? Hosp Pract. 2014;42:69-82.
• Anand R, Gill KD, Mahdi AA. Therapeutics of Alzheimer's disease: Past, present and future.
Neuropharmacology. 2014;76 Pt A:27-50.
• Atchison JW, Herndon CM, Rusie E. NSAIDs for musculoskeletal pain management: current
perspectives and novel strategies to improve safety. J Manag Care Pharm. 2013;19(Suppl A):S3-19.
• Bagshaw KR, Hanenbaum CL, Carbone EJ, et al. Pain management via local anesthetics and responsive
hydrogels. Ther Deliv. 2015;6:165-176.
• Biondi B, Wartofsky L. Treatment with thyroid hormone. Endocr Rev. 2014;35:433-512.
• Brietzke SA. Oral antihyperglycemic treatment options for type 2 diabetes mellitus. Med Clin North
Am. 2015;99:87-106.
• Buesing KL, Mullapudi B, Flowers KA. Deep venous thrombosis and venous thromboembolism
prophylaxis. Surg Clin North Am. 2015;95:285-300.
• Bunchorntavakul C, Reddy KR. Review article: herbal and dietary supplement hepatotoxicity. Aliment
Pharmacol Ther. 2013;37:3-17.
• Cameron C, Habert J, Anand L, Furtado M. Optimizing the management of depression: primary care
experience. Psychiatry Res. 2014;220(Suppl 1):S45-57.
• Chen SL. A review of drug therapy for functional dyspepsia. J Dig Dis. 2013;14:623-625.
• Chou R, Turner JA, Devine EB, et al. The effectiveness and risks of long-term opioid therapy for
chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med. 2015;162:276-286.
• Davis N, Lee M, Lin AY, et al. Postoperative cognitive function following general versus regional
anesthesia: a systematic review. J Neurosurg Anesthesiol. 2014;26:369-376.
• Giugni JC, Okun MS. Treatment of advanced Parkinson's disease. Curr Opin Neurol. 2014;27:450-460.
 • Hojjat-Farsangi M. Novel and emerging targeted-based cancer therapy agents and methods. Tumour
Biol. 2015;36:543-556.
• Huber K, Bates ER, Valgimigli M, et al. Antiplatelet and anticoagulation agents in acute coronary
syndromes: what is the current status and what does the future hold? Am Heart J. 2014;168:611-621.
• Hussain M, Berger M, Eckenhoff RG, Seitz DP. General anesthetic and the risk of dementia in elderly
patients: current insights. Clin Interv Aging. 2014;9:1619-1628.
• Kesselheim AS, Darrow JJ. FDA designations for therapeutics and their impact on drug development
and regulatory review outcomes. Clin Pharmacol Ther. 2015;97:29-36.
• Kew KM, Dias S, Cates CJ. Long-acting inhaled therapy (beta-agonists, anticholinergics and steroids)
for COPD: a network meta-analysis. Cochrane Database Syst Rev. 2014;3:CD010844.
• Khurana SR, Garg DS. Spasticity and the use of intrathecal baclofen in patients with spinal cord injury.
Phys Med Rehabil Clin N Am. 2014;25:655-669.
• Kinnear BZ, Lannin NA, Cusick A, et al. Rehabilitation therapies after botulinum toxin-A injection to
manage limb spasticity: a systematic review. Phys Ther. 2014;94:1569-1581.
• Lovich-Sapola J, Smith CE, Brandt CP. Postoperative pain control. Surg Clin North Am. 2015;95:301-
318.
• Meredith HR, Srimani JK, Lee AJ, et al. Collective antibiotic tolerance: mechanisms, dynamics and
intervention. Nat Chem Biol. 2015;11:182-188.
• Moßhammer D, Schaeffeler E, Schwab M, Mörike K. Mechanisms and assessment of statin-related
muscular adverse effects. Br J Clin Pharmacol. 2014;78:454-466.
• Pau AK, George JM. Antiretroviral therapy: current drugs. Infect Dis Clin North Am. 2014;28:371-402.
• Prentice RL. Postmenopausal hormone therapy and the risks of coronary heart disease, breast cancer,
and stroke. Semin Reprod Med. 2014;32:419-425.
• Sackett K, Carter M, Stanton M. Elders' use of folk medicine and complementary and alternative
therapies: an integrative review with implications for case managers. Prof Case Manag. 2014;19:113-
123.
• Santiago T, da Silva JA. Safety of glucocorticoids in rheumatoid arthritis: evidence from recent clinical
trials. Neuroimmunomodulation. 2015;22:57-65.
• Schofield ML. Asthma pharmacotherapy. Otolaryngol Clin North Am. 2014;47:55-64.
• Sousa F, Castro P, Fonte P, Sarmento B. How to overcome the limitations of current insulin
administration with new non-invasive delivery systems. Ther Deliv. 2015;6:83-94.
• Te Riet L, van Esch JH, Roks AJ, et al. Hypertension: renin-angiotensin-aldosterone system alterations.
Circ Res. 2015;116:960-975.
• Uhl RL, Roberts TT, Papaliodis DN, et al. Management of chronic musculoskeletal pain. J Am Acad
Orthop Surg. 2014;22:101-110.
• Vajda FJ, Eadie MJ. The clinical pharmacology of traditional antiepileptic drugs. Epileptic Disord.
2014;16:395-408.
• Vanichakarn P, Hwa J, Stitham J. Cardiovascular pharmacogenetics of antihypertensive and lipid-
lowering therapies. Curr Mol Med. 2014;14:849-879.
• Wallace J, Paauw DS. Appropriate prescribing and important drug interactions in older adults. Med Clin
North Am. 2015;99:295-310.
• Werner FM, Coveñas R. Safety of antipsychotic drugs: focus on therapeutic and adverse effects. Expert
Opin Drug Saf. 2014;13:1031-1042.

IX. AUDIOVISUAL MATERIALS

Students are responsible for having a computer with the following capability.
• Platform: Microsoft Windows XP or Mac OS.X v10.4+
• 1GB of RAM
• Flash Player 10
 • Pentium-class PC (1.0 GHz or higher recommended),
• 8x DVD-ROM drive or better,
• Microsoft Windows Media Player 8.0 (or higher),
• Microsoft Internet Explorer 8.0 (or higher), or other internet browser
• Acrobat Reader 5.0 or higher.

Downloads:
To obtain the most recent version of the Microsoft programs go to http://www.microsoft.com , click on
Downloads

To obtain adobe reader go to http://www.adobe.com, click on “get adobe reader”.

To obtain adobe reader go to http://www.adobe.com, click on “get adobe reader”.