CH 21: Disorders of Movement Flashcards
Disorders associated with movement are some of the most difficult conditions to treat because their
underlying mechanisms span other important systems in the body: the nervous, muscular, endocrine, and skeletal systems.
involuntary contractions of a skeletal muscle or group of skeletal muscles. The muscles become tightened and fixed, causing intense pain that usually diminishes after a few minutes. Chronic muscle spasms can impair joint function.
muscle spasms
possible causes of muscle spasms
overmedication with antipsychotic drugs, epilepsy, hypocalcemia, dehydration, and neurologic disorders
patients with muscle spasms may experience:
inflammation
edema
pain at the affected muscle
loss of coordination
reduced mobility
first and second line drugs for muscle spasms
1 - NSAIDs
2 - skeletal muscle relaxants
goal for muscle spasm drug therapy
Minimize pain, and discomfort, increase range of motion, improve function
treat muscle spasms at the brain and spinal cord level
Centrally Acting Skeletal Muscle Relaxants
skeletal muscle relaxants
Baclofen
cyclobenzaprine
imidazolines
clonidine
benzodiazepines
clonazepam
diazepam
condition in which muscle groups remain in a continuous state of contraction. Contracted muscles become stiff with increased muscle tone. Other signs and symptoms include mild to severe pain, exaggerated deep tendon reflexes, localized muscle spasms, scissoring (involuntary crossing of the legs), and fixed joints.
Spasticity
Treatment of spasticity
– PT and meds
– meds alone will not work
– regular exercise can decrease symptoms
work at the level of the neuro-muscular junction and skeletal muscles.
direct-acting antispasmodics
Dantrolene relieves spasticity by
interfering with the release of calcium ions in skeletal muscle.
direct acting antispasmodics
neuromuscular junction action
skeletal muscle action - relaxant
nicotinic blocking drugs interfere with the binding of
acetylcholine, thereby preventing voluntary muscle contraction.
two major classes of nicotinic blocking drugs
nondepolarizing blockers and depolarizing blockers.
Nondepolarizing blockers MOA
compete with acetylcholine for the receptor
depolarizing blockers MOA
bind to the acetylcholine receptor and produce a state of continuous depolarization.
concern of blocker medications is
overrelaxation of muscles (breathing)
non-depolarizing blockers ex
vecuronium - long duration
depolarizing blockers ex
succinylcholine - short duration
rare, life-threatening, anesthetic-related disorder that occurs in susceptible patients following the administration of a triggering agent, such as inhaled halogenated volatile anesthetics or succinylcholine.
Malignant hyperthermia
The signs of malignant hyperthermia include
muscle rigidity
rapid heart rate
high body temperature
muscle breakdown
increased acid content.
poor blood circulation to the legs
intermittent claudication
cylcobezaprine therapeutic effects
relieves muscle spasms of local origin without interfering with general muscle function
adverse effects of imidazolines
dry mouth
impotence
sedation
lethargy
orthostatic hypotension
bacterium responsible for botulism food poisoning
clostridium botulinum
produces effect by blocking the release of ACH from cholinergic nerve terminals
botulinum toxin
adverse effects of neuromuscular junction action
Headache
dysphagia
ptosis
local muscle weakness
pain
muscle tenderness
Anaphylaxis, dysphagia, death
calcium release blockers MOA
interferes with the release of calcium ions from storage areas inside skeletal muscle cells.
skeletal muscle relaxant black box warning
Hepatitis and deaths due to liver failure have occurred with dantrolene.
