Intravenous administration introduces the drug into systemic circulation immediately and provides complete absorption. Both intramuscular and subcutaneous administrations allow faster and more complete absorption than oral administration, although subcutaneous administration is slower than intramuscular methods. Intramuscular injections tend to be more painful than subcutaneous injections but facilitate larger dosages of the drug, which are not possible in subcutaneous administration (Kim & De Jesus, 2023). The Food and Drug Administration gives a list of 35 categories of drugs. These categories are important to become familiar with not only for awareness about possible contraindications and interactions with massage but also to help inform you and give you a broader awareness of the needs of the client. For instance, if you see an antihistamine (allergy medication) listed, you may want to verbally confirm with your client if they have any allergies or sensitivities to any scents, oils, or even detergents. You may also want to change the positioning of the massage; for someone suffering from seasonal allergies, being prone (face down) on the table for any length of time may cause further irritation to their sinuses. Here we see how a medication, although it doesn’t have a contraindication for massage, can give you further surrounding information to create an informed and effective treatment plan (U.S. Food & Drug Administration, 2015). Some of the more important categories, contraindications, and considerations surrounding those drugs are described in the following sections. to check in with the client about pressure throughout the massage, especially if working in an affected pain area. Common medication names: ● Non-narcotic: acetemenophin, ibeprofen, naproxen, aspirin ● Narcotic: codeine, fentanyl, hydrocodone, oxycodone, meperidine (Cleveland Clinic, 2018) Healthcare Consideration: Anti-inflammatories may alter mood as well as pain perception; therapists should not perform any massage likely to increase inflammation. Changes in client stress levels can also influence the effects of steroids and thyroid medications. Additionally, steroids can cause inflammation, so therapists should avoid massage methods that tend to increase the inflammatory response. massage techniques that are very effective at relaxing the parasympathetic nervous system and can used safely with the client experiencing anxiety. Aromatherapy can also be a great way to enhance the massage for someone taking anxiety medication, but it is important to check with the client first about any allergies, or especially aversions, as certain smells can actually trigger anxiety for some people. When changing positions on the table with the client taking anxiety medications, be sure to have them move slowly, and when finishing the massage, reiterate for them to get up slowly from the table, due to the dizziness or lightheadedness that can accompany the medication and the disorientation after an extended period of time on the table. Common medication names: ● Celexa, Lexapro, Paxil, Prozac, Luvox
Orally administered medications, which are taken by mouth, may be in the form of a solid pill, tablet, capsule, or lozenge but may also be powder or granular in form. Orally administered preparations also take the form of liquids and may be referred to as solutions , emulsions , syrups , or tinctures , among other names. Oral medication is convenient but may be slower and less complete than dosage through parenteral (non-oral) channels. Solid medication must be dissolved and withstand exposure to stomach acid. Additionally, oral medications are subject to metabolism by the gut and liver before reaching circulation (first-pass effect). Sublingual medications are directly absorbed into systemic venous circulation, avoiding the first-pass effect. The absorption can vary from fast to slow, according to the composition of the drug. Inhalation drugs are commonly used for respiratory diseases, as this method brings the drug into close contact with the target organ (the lungs). Suppositories are also directly absorbed into systemic venous circulation. This method allows for the absorption of larger doses of a drug and may be useful for patients who cannot use sublingual or orally administered medication. Some drugs are administered parenterally, meaning they enter the body through a route other than the alimentary (gastrointestinal) tract. Parenteral administration includes injection or infusion of a sterile preparation into the tissue, and it includes the use of subcutaneous, intramuscular, intravenous, intrathecal and intra-articular routes. Analgesics These drugs are used for pain relief and management. Non- narcotic analgesics are used to treat minor aches and pains, and narcotic analgesics can be used for more severe pain. Contraindications: Use caution; avoid deep tissue work. Considerations: With either narcotic or non-narcotic analgesics, these drugs affect pain receptors, so the client’s ability to give feedback about pressure or discomfort during the massage may be affected, due to them not having the normal sensitivity from taking medication for pain. Taking of analgesics may also indicate chronic pain, headaches, or inflammation. If the client has not listed any areas of discomfort, past injuries, or recent operations, it is worth asking again about any pain complaints, dosage, or doctor recommendations. Deep tissue work with analgesics is not recommended, and be ure Anti-anxiety drugs These are medicines used to treat anxiety and relax muscle tissue. Contraindications : No direct contraindications; however, many anti-anxiety medications, especially at the beginning of treatment, can cause side effects such as dizziness, headaches, and lightheadedness, so it is important to be aware of this and make any necessary adjustments to the massage. These adjustments may be changing technique, lessening pressure, or changing position. Working in a side-lying position and supine may be most effective for clients experiencing any of the aforementioned symptoms. Considerations : Massage is a very effective complementary medicine to treat depression and anxiety. A client who is taking anxiety medication may be more likely to be seeking massage therapy for relaxation and stress relief. Long, firm compressions, rocking, and milking are three
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