Pharmacology in Rehabilitation Study Guide (2026/2027 Syllabus)
Chapter 1: Basic Principles of Pharmacology
1. What is the difference between pharmacokinetics and pharmacodynamics?
ANSWER ✓ Pharmacokinetics is "what the body does to the drug" (absorption,
distribution, metabolism, excretion). Pharmacodynamics is "what the drug does to the
body" (the mechanism of action and therapeutic effects at receptor sites).
2. Define bioavailability and name one factor that influences it.
ANSWER ✓ Bioavailability is the fraction of an administered drug that reaches the
systemic circulation unchanged. A key factor is first-pass metabolism in the liver, which
reduces bioavailability for many orally administered drugs.
3. What is the therapeutic index (TI), and why is it clinically important?
ANSWER ✓ The therapeutic index is the ratio between a drug's toxic dose (TD50 or
LD50) and its therapeutic dose (ED50). A high TI indicates a wide margin of safety, while
a low TI indicates a narrow safety window, requiring close monitoring.
4. Explain the concept of a drug's half-life (t½).
ANSWER ✓ A drug's half-life is the time required for the plasma concentration of the
drug to be reduced by 50%. It determines the dosing frequency and the time to reach
steady state.
5. What is the primary goal of Phase III clinical trials?
ANSWER ✓ Phase III trials are large-scale studies designed to confirm a drug's
effectiveness, monitor side effects, compare it to standard treatments, and collect
information for safe usage.
Chapter 2: Autonomic and Cardiovascular Pharmacology
6. How do beta-blockers (e.g., metoprolol) affect heart rate and blood pressure,
and what is a key rehab consideration?
ANSWER ✓ Beta-blockers decrease heart rate, myocardial contractility, and blood
pressure. A key rehab consideration is monitoring for exaggerated bradycardia and
hypotension during exercise, and potentially impaired thermoregulation.
7. What is the mechanism of action of statins (e.g., atorvastatin)?
ANSWER ✓ Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in cholesterol
synthesis in the liver, thereby lowering LDL cholesterol and triglycerides.
, 8. Describe a major musculoskeletal side effect of statin therapy.
ANSWER ✓ Statins can cause myalgia (muscle pain), muscle weakness, and, in severe
cases, rhabdomyolysis (muscle breakdown), which is a critical concern for therapists
monitoring exercise tolerance.
9. How do ACE inhibitors (e.g., lisinopril) work to lower blood pressure?
ANSWER ✓ ACE inhibitors block the angiotensin-converting enzyme (ACE), preventing
the formation of angiotensin II (a potent vasoconstrictor) and decreasing aldosterone
secretion, leading to vasodilation and reduced blood volume.
10. What is a common, dry side effect of ACE inhibitors?
ANSWER ✓ A persistent, dry, non-productive cough is a common side effect of ACE
inhibitors, occurring in up to 20% of patients.
11. What is the primary use of warfarin (Coumadin), and what dietary interaction
is critical?
ANSWER ✓ Warfarin is an oral anticoagulant used to prevent blood clots. Vitamin K
intake (found in green leafy vegetables) can antagonize its effect, so patients must
maintain a consistent dietary intake.
12. How do direct oral anticoagulants (DOACs like apixaban) differ from warfarin?
ANSWER ✓ DOACs have a more predictable pharmacokinetic profile, do not require
routine INR monitoring, have fewer dietary interactions, but lack a universally available
reversal agent for all drugs in the class.
13. What is the role of nitroglycerin, and what is a crucial administration
instruction?
ANSWER ✓ Nitroglycerin is a vasodilator used for acute relief of angina pectoris. It is
administered sublingually, and patients must be seated to prevent orthostatic
hypotension and fainting.
Chapter 3: Psychopharmacology in Rehabilitation
14. What are the primary classes of drugs used to treat major depressive disorder?
ANSWER ✓ Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine
reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic antidepressants (TCAs),
and monoamine oxidase inhibitors (MAOIs).
15. Name two common side effects of SSRIs (e.g., sertraline) relevant to PT.
ANSWER ✓ Increased risk of bleeding/bruising (due to mild antiplatelet effect) and
initial activation side effects like anxiety or agitation, which can impact exercise
participation.
Chapter 1: Basic Principles of Pharmacology
1. What is the difference between pharmacokinetics and pharmacodynamics?
ANSWER ✓ Pharmacokinetics is "what the body does to the drug" (absorption,
distribution, metabolism, excretion). Pharmacodynamics is "what the drug does to the
body" (the mechanism of action and therapeutic effects at receptor sites).
2. Define bioavailability and name one factor that influences it.
ANSWER ✓ Bioavailability is the fraction of an administered drug that reaches the
systemic circulation unchanged. A key factor is first-pass metabolism in the liver, which
reduces bioavailability for many orally administered drugs.
3. What is the therapeutic index (TI), and why is it clinically important?
ANSWER ✓ The therapeutic index is the ratio between a drug's toxic dose (TD50 or
LD50) and its therapeutic dose (ED50). A high TI indicates a wide margin of safety, while
a low TI indicates a narrow safety window, requiring close monitoring.
4. Explain the concept of a drug's half-life (t½).
ANSWER ✓ A drug's half-life is the time required for the plasma concentration of the
drug to be reduced by 50%. It determines the dosing frequency and the time to reach
steady state.
5. What is the primary goal of Phase III clinical trials?
ANSWER ✓ Phase III trials are large-scale studies designed to confirm a drug's
effectiveness, monitor side effects, compare it to standard treatments, and collect
information for safe usage.
Chapter 2: Autonomic and Cardiovascular Pharmacology
6. How do beta-blockers (e.g., metoprolol) affect heart rate and blood pressure,
and what is a key rehab consideration?
ANSWER ✓ Beta-blockers decrease heart rate, myocardial contractility, and blood
pressure. A key rehab consideration is monitoring for exaggerated bradycardia and
hypotension during exercise, and potentially impaired thermoregulation.
7. What is the mechanism of action of statins (e.g., atorvastatin)?
ANSWER ✓ Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in cholesterol
synthesis in the liver, thereby lowering LDL cholesterol and triglycerides.
, 8. Describe a major musculoskeletal side effect of statin therapy.
ANSWER ✓ Statins can cause myalgia (muscle pain), muscle weakness, and, in severe
cases, rhabdomyolysis (muscle breakdown), which is a critical concern for therapists
monitoring exercise tolerance.
9. How do ACE inhibitors (e.g., lisinopril) work to lower blood pressure?
ANSWER ✓ ACE inhibitors block the angiotensin-converting enzyme (ACE), preventing
the formation of angiotensin II (a potent vasoconstrictor) and decreasing aldosterone
secretion, leading to vasodilation and reduced blood volume.
10. What is a common, dry side effect of ACE inhibitors?
ANSWER ✓ A persistent, dry, non-productive cough is a common side effect of ACE
inhibitors, occurring in up to 20% of patients.
11. What is the primary use of warfarin (Coumadin), and what dietary interaction
is critical?
ANSWER ✓ Warfarin is an oral anticoagulant used to prevent blood clots. Vitamin K
intake (found in green leafy vegetables) can antagonize its effect, so patients must
maintain a consistent dietary intake.
12. How do direct oral anticoagulants (DOACs like apixaban) differ from warfarin?
ANSWER ✓ DOACs have a more predictable pharmacokinetic profile, do not require
routine INR monitoring, have fewer dietary interactions, but lack a universally available
reversal agent for all drugs in the class.
13. What is the role of nitroglycerin, and what is a crucial administration
instruction?
ANSWER ✓ Nitroglycerin is a vasodilator used for acute relief of angina pectoris. It is
administered sublingually, and patients must be seated to prevent orthostatic
hypotension and fainting.
Chapter 3: Psychopharmacology in Rehabilitation
14. What are the primary classes of drugs used to treat major depressive disorder?
ANSWER ✓ Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine
reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic antidepressants (TCAs),
and monoamine oxidase inhibitors (MAOIs).
15. Name two common side effects of SSRIs (e.g., sertraline) relevant to PT.
ANSWER ✓ Increased risk of bleeding/bruising (due to mild antiplatelet effect) and
initial activation side effects like anxiety or agitation, which can impact exercise
participation.
