BOSTON — If a patient experiences difficulties with socket fit or swelling, sometimes the symptoms may be related to a medication that the patient is taking. Megan Ehret, PharmD, BCPP, associate professor of pharmacology practice at the University of Connecticut, discussed how aspects of pharmacology affect the orthotic, prosthetic and pedorthic industries at the American Orthotic and Prosthetic Association National Assembly here.
According to Ehret, 47.9% of people in the United States have used at least one prescription drug in the past month.
“More likely than not at least half of the patients walking through your door are going to be taking something,” Ehret said. “So if you are seeing that there might be something else going on with your patient, behavioral changes or anything psychologically, perhaps you are doing the right thing, but there might be something else affecting the patient.”
Because of the high prevalence of prescription medications, it is important that clinicians conduct a thorough medical history before treating patients to fully understand the medications the patients are taking and how they might affect treatment.
“You should ask patients to write a detailed list before they come to your office so they don’t forget any,” Ehret said. “Or ask patients to bring every single medication with them.”
Some of the specific medications that Ehret discussed were hypertension medications, which are diuretics and can affect swelling of the residual limb; blood thinners and anti-platelet drugs, which can cause excessive bleeding and hinder healing in open wounds; and pain medications, which can affect how a patient responds to brace fit. She also addressed certain kinds of muscle relaxants that can induce dizziness and affect balance and coordination.
Ehret also emphasized the commonality of herbal medications and dietary supplements. Both can be manufactured and sold without demonstrating safety or efficacy and may cause side effects such as restlessness, hyperactivity, bleeding and hypertension, among others.
“These are not regulated by the Food and Drug Administration,” Ehret said. “So we recommend asking patients if they are taking or have taken any kind of herbal product, because something you are seeing may be linked to an over-the-counter medication they are taking.”
Ehret encourages all clinicians to develop a relationship with a pharmacist who can help them with any drug-related issues.
“Everybody should get to know a pharmacist. They are one of the most accessible health care providers,” Ehret said. “There is a drug store open 24/7 everywhere, and there will be a pharmacist there who can answer questions that come up as you evaluate a patient. They are up to date on drug-to-drug interactions and can help you determine if a drug if causing a problem.”
For more information:
Ehret, M. Impact of pharmacology on the orthotic, prosthetic and pedorthic patient population. Presented at the American Orthotic & Prosthetic Association National Assembly 2012. Sept. 6-9, Boston.