3. Neuromuscular disorders

Question 1

Quinine

Answer 1

Reduces the excitability of motor neurones that are attached to muscle fibres

Question 2

Quinine uses

Answer 2

• Malaria
• Nocturnal leg cramps

Should only be used if passive exercise stretches do not work and if quinine regularly disrupts sleep

Question 3

Quinine side effects

Answer 3

The serious side effects have been listed

Side effects:
* Toxic in overdose
* blindness, tinnitus
* Prolongs QT interval (risk increases as dose gets higher) . CAUTION in risk factors for QT prolong such as hyPOkalaemia, heart block, electrolyte disturbances

Question 4

Baclofen

Answer 4

GABA analogue, blocks neurotransmission at spinal level which relaxes muscles

Question 5

Baclofen uses

Answer 5

Chronic severe muscle spasms (i.e in multiple sclerosis)
Pallitaive care

Question 6

Baclofen side effects and route of administration

Answer 6

• muscular hypotonia (reduced muslce tone similar to a floppy baby)
• Drowsiness - warning in driving
• Avoid abrupt withdrawal - can cause serious withdrawal symptoms

route: intrathecal BUT do test dose, closely monitor, have resuscitation facilities near