Central nervous system medications, such as anti- anxiety medications, antipsychotics, antidepressants, amphetamines, and opioids, can influence or have effects influenced by massage. Depending on the type of massage, it may either increase or decrease the effectiveness of these Anti-arrhythmics These drugs are used to control irregularities in cardiac rhythms. Contraindications : Cautioned. Considerations: Anti-arrhythmics can themselves have a variety of side effects including swelling in the legs (that can be the beginning of deep vein thrombosis, which would be a general contraindication for massage unless explicitly given permission from the doctor), as well as dizziness, lightheadedness, chest discomfort, and irregular heart beat. It is important to know how they will react, and also be sure to explain the risk of bruising to the client. Often, clients will be on these medications for an underlying heart condition, arrythmia, or surgery, so when you or the client are in doubt of dosage or side effects, be sure to talk with their physician before treatment. Antibiotics These are medicines that fight limited or large spectra of bacteria and are made from naturally or synthetic substances. Contraindications: Cautioned. In general, massage is considered safe for clients taking antibiotics to receive, as long as they have been taking the medication for three days and there are no visible signs that infection is still present, such as redness, swelling, or fever. Considerations: There are differing opinions about receiving massage while taking antibiotics, with one opinion that massage can aid in the body’s natural ability to push out infection by activating lymphatic and immune systems. On the contrary view, massage being a great aid to the body for circulation, it is thought that massage would actually spread the infection throughout the body, making it harder for the antibiotics to do their job. It is up to the practitioner to decide which route to take, and determining the reason Anticoagulants and thrombolytics Anticoagulants aid in the prevention of blood clots forming, and thrombolytics help dissolve and disperse blood clots. Contraindications: General contraindications—massage therapy with clients who are taking blood thinners (anticoagulants and thrombolytics) is generally contraindicated due to risks of bruising and internal bleeding. The pressure of massage combined with circulatory effects can cause the blood vessels to burst, and because the blood does not clot as it normally would, then the blood pools underneath the skin, causing bruising. Internal bleeding happens in particular Anticonvulsants These are medications that prevent epileptic seizures. Contraindications: No direct interaction between massage and anticonvulsant drugs Considerations: Although there may be no direct interaction between the massage and the anticonvulsant drug, the reason
medications. With any of these drugs, it is important to work in conjunction with the treating professional, carefully monitor the dosage, and note any perceived increase or decrease in the medication’s effect (Leonard & Ames, 2022).
Common medication names: Lidocaine, Amiodarone, Propafenone, Ibutilide
Healthcare Consideration: Massage can magnify the effects of vasodilators used in the treatment of stroke or high blood pressure. Beta blockers, calcium channel blockers, antihypertensives, and antiarrhythmics used to treat angina, arrhythmias, and migraines can also be altered through the effects of massage as they slow the heart rate and reduce blood pressure. Clients using these drugs may become dizzy after massage and should be encouraged to contract and relax leg muscles for a few minutes before leaving the table. Clients using anticoagulants like heparin and warfarin can experience increased bruising, joint swelling, and aching; therefore, methods with a potential for bruising should be avoided. for taking the antibiotics can also be helpful. If the client is not forthcoming with information about reasons for taking the antibiotics, or the length of time they are taking them, it may be safer to refuse treatment until the antibiotic cycle has been completed. Be gracious, and offer to reschedule them for a future appointment. Common medication names: Amoxicillin, doxycycline, cephalexin, metronizadole, levofloaxin, clyndamycin Anti-infectives, such as antivirals or antifungals, compromise the immune system. Use universal precautions as necessary, and avoid exposing clients to contagious diseases. Respiratory medications like expectorants, decongestants, bronchodilators, and antihistamines can reduce perspiration. Antihistamines can both excite or depress the nervous system, altering the effects of the massage. Most of the medications in this class can also cause either drowsiness or anxiety (Cutler, 2008). with deep tissue massage and is considered a medical emergency. Considerations: The only type of massage that is safe to receive when taking blood thinners is very light massage, with no deep pressure, tapotements, or deep tissue work. Lymphatic drainage may be approved, but for any massage for clients who are taking blood thinners, a doctor’s permission is strongly suggested. Common medication names: Eliquis, Pradaxa, Lixiana, Coumadin, Retavase, Urokinase (Werner, 2021) for someone to be taking this medication is to treat re- occurrent seizures, so it is important for you to take certain precautions and know how to react if the client were to have a seizure during the massage. This may include having extra pillows close by in the room to help bolster and protect the client if they begin to seize. If the client is face down on the table, try and keep them on the table and use a pillow on the sides to prevent bruising from any movement. If they
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