Komisky-central Relaxants Flashcards
Duloxetine
Serotonin and norepinephrine reuptake inhibitor
Most effective for mood
Used for FM
Pregabalin
Calcium channel blocker
Used for FM
Milnacipran
Serotonin and norepinephrine reuptake inhibitor
Less effective for pain and lack of sleep
Used for FM
Do not use with MAOI
adverse effects will decrease with use
Baclofen
GABA B agonist
Centrally acting
Antispasticity-first line
Tizanidine
Alpha 1 and 2 agonist
Indication: MS or spinal cord injury
Contraindications: severe hepatic impairment
Adverse effects: drowsiness, fatigue, dizziness, dry mouth, nausea, GI, bradycardia, insomnia, hallucinations
first line anti spasticity
Other uses: Trigeminal neuralgia, chronic low back pain, cluster chronic headache, spasmodic torticollis, neuropathic pain,
Diazepam
Adjuvant therapy for spasticity
GABA A agonist
Clonazepam
Adjuvant for spasticity
Dantrolene sodium
Adjuvant anti spasticity
Clonidine
Adjuvant anti spasticity
Alpha 2 agonist
Reduces sympathetic : decreased bp and heart rate
Botulinum toxin
Local SE: pain/discomfort with injection, muscle weakness, atrophy
General: dry mouth, dysphasia, rash, palpitations
Immune resistance
Cost
Cyclobenzaprine
Duration is 12-24 hours
Some efficacy for FM used for chronic low back pain
Nocturnal muscle spasm effects
SE: drowsiness, anticholinergic (dry mouth, blurred vision, urine retention, constipation, increase intraocular pressure) cardiac dysrhythmias
Carisoprodol
Precursor of meprobamte
Reduction of muscle spasm
Side effect: drowsiness, dependence, sedation
Withdrawal: agitation, anorexia, N/V, hallucination, seizures
Used for: chronic low back pain
Methocarbamol
Investigative use for MS, used for low back pain
Inhibits post synaptic reflexes, reduces muscle spasms
Side effect: drowsiness
Metaxalone
Reduce muscle spasm
SE: nausea, drowsiness, dizziness
Used for low back pain
Orphenadrine citrate
Investigative use: SCL
Analog of diphenhydramine
Side effect: anticholinergic , rare aplastic anemia
Use for low back pain
