E. Neuromuscular Disorders

Question 1

Multiple sclerosis MS

Answer 1

• patho- autoimmune disorder
• attacks myelin sheath of nerve fibers
• cause lesions & plaques
• CHARACTERISTICS: extremity weakness and spasticity ( muscular hyperactivity)
• diplopia

Question 2

Skeletal muscle relaxants

Centrally acting

Answer 2

• baclofen (Lioresal)

- tizanidine ( zanaflex ) –used for MS or for spasticity assoc. with spinal chord injury

Question 3

Skeletal muscle relaxants

Direct acting

Answer 3

Dantrolene( dantrium) - used for MS & spinal cord injuries

Question 4

Skeletal muscle relaxants

Use

Answer 4

• suppress muscular hyperactivity

- relax muscles in spasm

Question 5

Skeletal muscle relaxants

SE

Answer 5

Drowsiness, sedation, dizziness(common with all muscle relaxants )

Question 6

Skeletal muscle relaxants

Nurse interventions

Answer 6

• talk with food
• monitor liver function
• check VS
• do not allow to drive
• do not stop abruptly ( discontinue over a week to avoid rebound spasm)
• avoid alcohol and other depressants

Question 7

Myasthenia Gravis ( MG)
Patho & characteristics

Answer 7

• patho : - autoimmune disease, lack of nerve impulses and muscle responses at myoneural junction
• lack of acetylcholine reaching cholinergic receptors

Question 8

Myasthenia Gravis ( MG)
Characteristics

Answer 8

Muscular weakness and fatigue

- respiratory muscle paralysis

Question 9

Cholinesterase inhibitors

Answer 9

• used for diagnosing MG
• action: transmission of neuromuscular impulses by preventing destruction of ACh
• use: control and treat MG

Question 10

Cholinesterase inhibitors

SE/ warnings

Answer 10

Underdosed : myasthenia crisis - severe muscle weakness , improves after edrophonium

Question 11

Cholinesterase inhibitors

Nursing interventions

Answer 11

• administer doses on time
• take drug before meals if possible
• monitor drug effectiveness
• have antidote available for cholinergic crisis( Atropine)