Drugs for Neuromuscular Disorders and Muscle Spasms Flashcards

1
Q

is an acquired autoimmune disease that impairs the transmission of messages at the neuromuscular junction, resulting in varying degrees of skeletal muscle weakness that increases with muscle use

A

myathenia gravis (MG)

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2
Q

___ may result from respiratory muscle paralysis in MG

A

respiratory arrest

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3
Q

the symptoms of MG are caused by autoimmune destruction of ___ sites and a resultant decrease in neuromuscular transmission

A

ACh

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4
Q

patho of MG

A

autoimmune process in which antibodies attack ACh receptors. The result is a decreased amount of AChR sites at the neuromuscular junction. This prevents ACh molecules from attaching to receptors and stimulating normal muscular contraction

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5
Q

when muscular weakness in the patient with MG becomes generalized, ___ can occur. This complication is a severe, generalized muscle weakness that involves the muscles of respiration, such as the diaphragm and intercostal muscles

A

myathenic crisis (underdose of AChE inhibitors dose q 2-4 hrs to prevent)

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6
Q

if the muscle weakness from a myathenic crisis remains untreated, death can result from paralysis of the respiratory muscles.

____ a fast-acting AChE inhibitor, can relieve a myathenic crisis

A

neostigmine

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7
Q

overdosing with AChE inhibitors may cause another complication if MG called ____

is an acute exacerbation of symptoms

A

cholinergic crisis

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8
Q

a cholinergic crisis usually occurs within ___ after taking anticholinergic drugs

A

30-60 min

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9
Q

symptoms/manifestations of MG

A

weakness of skeletal muscles, ptosis, diplopia, dysphagia, dysarthria (slurred speech), and respiratory muscle weakness

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10
Q

common triggers of a myatheic crisis

A

underdose of AChE inhibitors, infection, emotional stress, menses, pregnancy, surgery, trauma, hypokalemia, temp extremes, and alcohol intake

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11
Q

manifestations of cholinergic crisis

A

miosis, pallor, sweating, vertigo, excessive salivation, N/V, abdominal cramping, diarrhea, bradycardia

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12
Q

what is the AChE inhibitor that is given to differentiate between a myathenic and cholinergic crisis

A

edrophonium chloride

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13
Q

an intermediate acting AChE inhibitor that is given IV undiluted for treatment of MG

A

pyridostigmine

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14
Q

what is the antidote to an AChE inhibitor like pyridostigmine

A

atropine (anticholinergic)

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15
Q

patients who do not respond to AChE inhibitors may require additional drug treatment such as ___

A

prednisone, plasma exchange, IV immune globulin, or immunosuppressive drugs (azathioprine)

monitor CBC and LFTs

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16
Q

an autoimmune disorder that attacks the myelin sheath of nerve fibers in the brain and spinal cord, which results in lesions called plaques

A

Multiple Sclerosis (MS)

a condition with remissions and exacerbations

17
Q

motor symptoms of MS

A

weakness or paralysis of limbs, muscle spasticity

18
Q

Diagnostics used to diagnose MS

A

medical hx, neurological exam, MRI, evoked potential (test that measures the electrical activity of the brain)

19
Q

disease-modifying drugs and are the first line treatment for pts with MS

can slow the progression of the disease and prevent relapse

A

immunodulators

**interferon beta 1-a and 1-b

20
Q

relieve muscular spasms and pain associated with traumatic injuries and spasticity from chronic debilitating disorders

A

skeletal muscle relaxants

21
Q

depress neuron activity in the spinal cord or brain and enhance neuronal inhibition of the skeletal muscles

A

centrally acting muscle relaxants

22
Q

example of a centrally acting muscle relaxant and implications

A

cyclobenzaprine

no alcohol, no pregnancy, take w/ food, and at bedtime
take a week to taper

used for acute muscle spams do not take > 3 wks

23
Q

muscle relaxants used for skeletal muscle spasticity and muscular hyperactivity that causes contraction of the muscles, resulting in limited pain and mobility

A

baclofen, dantrolene, tizanidine

do not take with other depressants