Drugs for Neuromuscular Disorders and Muscle Spasms

Question 1

An acquired autoimmune disease that impairs the transmission of messages at the neuro-muscular junction, resulting in fluctuating muscle weakness that increases with muscle use

Answer 1

Myasthenia Gravis

Question 2

A neuromuscular autoimmune disorder that attacks the myelin sheath of nerve fibers, causing lesions know as plaques

Answer 2

Multiple Sclerosis

Question 3

Muscle contractions resulting from various causes, including injury or motor neuron disorders

Answer 3

Muscle spasms

Question 4

Agents that reduce spasticity of muscles

Answer 4

Muscle relaxants

Question 5

Occurs when muscular weakness in the patient with myasthenia gravis becomes generalized

Answer 5

Myasthenic crisis

Question 6

Overdosing with acetylcholinesterase inhibitors; may complicate myasthenia gravis

Answer 6

Cholinergic crisis

Question 7

Involuntary muscle twitching

Answer 7

Fasciculations

Question 8

Why is thymectomy used to treat Myasthenia Gravis?

Answer 8

It is thought that the thymus is the source of the antibodies that are destroying the acetylcholine receptors.

Question 9

What are characteristics of Myasthenia Gravis?

Answer 9

Skeletal muscle weakness, fatigue, ptosis, dysphagia, dysarthria, respiratory muscle weakness.

Question 10

Myasthenic crisis can be caused by:

Answer 10

Not enough medication, stress, menses, pregnancy, surgery, trauma, low K levels, temperature extremes, alcohol.

Question 11

The drug of choice for myasthenic crisis is:

Answer 11

Neostigmine

Question 12

Cholinergic crisis is caused by:

Answer 12

Too much medication (acetylcholinesterase inhibitor)

Question 13

Cholinergic crisis is treated with:

Answer 13

Atropine

Question 14

Which drug can be used to differentiate between myasthenic and cholinergic crisis?

Answer 14

Edrophonium

Question 15

Patients with Myasthenia Gravis who do not respond to anticholinesterase inhibitors may:

Answer 15

Undergo plasma exchange. They may also be given Intravenous immune globulin or immunosuppressive drugs.

Question 16

What is damaged in patients with Multiple Sclerosis?

Answer 16

The myelin sheath covering the nerve fibers.

Question 17

How is MS diagnosed?

Answer 17

Medical history, neurologic exam, MRI, lumbar puncture

Question 18

Which type of MS occurs in about 85% of cases?

Answer 18

Relapsing remitting

Question 19

What types of meds are used to treat MS?

Answer 19

Immunomodulators, Beta-interferon, Corticosteroids

Question 20

True or false: Corticosteroids are used to treat acute exacerbations of MS.

Answer 20

True

Question 21

Which muscle relaxant does not cause drug dependence?

Answer 21

Cyclobenzaprine.

Question 22

True of False: Muscle relaxants may be used long term with no serious adverse effects.

Answer 22

False

Question 23

True of False: Patients should not stop taking muscle relaxants abruptly.

Answer 23

True

Question 24

what ACH inhibitors do we use for myasthenia graves?

Answer 24

Endrophonium
Neostigmine
Pyridostigmine
Ambenoium

Question 25

If a patient does not respond to ACH inhibitors, what would be the drug of choice?

Answer 25

Prednisone

Question 26

Relapsing remitting

Answer 26

relapse with full recovery & residual deficit

Question 27

primary progressive

Answer 27

slowly worsening neuro function without relapse

Question 28

secondary progressive

Answer 28

relapse remitting, then progressive with or without occasional relapses, minor remissions

Question 29

progressive relapsing

Answer 29

progressive from onset with acute relapse with or without full recovery

Question 30

central acting muscle relaxants

Answer 30

Baclofen Carisoprodol Chlorozoxazone Methocarbamol