Kruse - centrally activng skeletal muscle relaxants

Question 1

Name the spasmolytic with MOA: agonist at GABAB receptors; results in hyperpolarization (due to increased K+ conductance) and inhibition of excitatory neurotransmitter release in the brain and spinal cord

Answer 1

baclofen

Question 2

What drug is used to treat reversible spasticity associated with multiple sclerosis or spinal cord lesions with less overall loss of muscle strength than dantrolene

Answer 2

baclofen

Question 3

AE of baclofen

Answer 3

drowsiness, increased seizure activity

Question 4

Spasmolytic with MOA: CNS depressant, Metabolized to meprobamate, which has anxiolytic and sedative effects

Answer 4

carisoprodol

Question 5

What are the two spasmolytics that are schedule 4 category of controlled drugs?

Answer 5

carisoprodol and diazepam

Question 6

Use of carisoprodol

Answer 6

short term for MSK pain (2-3 weeks)

Question 7

Use caution when administering what two drugs with CYP450 inhibitors?

Answer 7

• carisoprodol - metabolized by CYP2C19

- cyclobenzaprine

Question 8

What drug is ineffective in treating muscle spasm due to cerebral palsy or spinal cord injury

Answer 8

cyclobenzaprine

Question 9

What drug related to tricyclic antidepressants and may cause significant sedation, confusion, and transient visual hallucination - why these adverse effects?

Answer 9

cyclobenzaprine - produces antimuscarinic side effects

Question 10

drowsiness, dizziness, and xerostomia - AE of ___

Answer 10

cyclobenzapine

Question 11

What drug has MOA: promote binding of GABA (the major inhibitory neurotransmitter in the CNS) to the GABAA receptor, enhancing GABA-induced ion currents (increase frequency of channel openings); leads to increased inhibitory transmission and a reduction in spasticity

Answer 11

diazepam

Question 12

Effect of diazepam at dose required to reduce muscle tone.

Answer 12

sedation

Question 13

What drug is used to tx muscle spasticity and has MOA: alpha2-adrenergic agonist (chemically similar to clonidine) that decreases excitatory input to alpha motor neurons

Answer 13

tizanidine

Question 14

Dantrolene is CI in pts with ___

Answer 14

hepatitis

Question 15

What drug has MOA: cleaves components of the core SNARE complex involved in exocytosis, preventing the release of ACh

Answer 15

botulinum toxin

Question 16

four drugs used for Multiple sclerosis

Answer 16

glucocorticoids, glatiramer acetate, IFN-B-1a/b, mitoxantrone

Question 17

What drug is used to treat spasticity associated with upper motor neuron disorders (eg, spinal cord injury, stroke, cerebral palsy, or multiple sclerosis)

Answer 17

Dantrolene (and management of malignant hyperthermia)

Question 18

What drug class has this use: a. monthly IV bolus of methylprednisolone used to treat primary or secondary progressive MS +/- immunosuppressants

Answer 18

Glucocorticoids

Question 19

What drug has MOA: Mixture of four amino acids (L-alanine, L-glutamic acid, L-lysine, and L-tyrosine) - antigenically similar to myelin basic protein, which is an important component of the myelin sheath of nerves
Thought to induce and activate T-lymphocyte suppressor cells specific for a myelin antigen; also proposed to interfere with the antigen-presenting function of certain immune cells opposing pathogenic T-cell function

Used for…

Answer 19

Glatiramer acetate

used for relapsing-remitting type MS

Question 20

Drug with MOA: Acts on blood-brain barrier by interfering with T-cell adhesion to the endothelium by binding VLA-4 on T cells or by inhibiting the T-cell expression of MMP

Answer 20

IFN-B-1a and IFN-B-1b

Question 21

IFN-B-1a and IFN-B-1b treatment result in…?

Answer 21

in a reduction of relapses by one-third, a reduction of new MRI T2 lesions and the volume of enlarging T2 lesions, a reduction in the number and volume of Gd-enhancing lesions, and a slowing of brain atrophy

Question 22

Drug with MOA: Antineoplastic agent used to treat MS, acute myeloid leukemia, and advanced, hormonerefractory prostate cancer

Answer 22

mitoxantrone

Question 23

MOA of mitoxantrone

Answer 23

intercalates into DNA resulting in cross-links and strand breaks (related to anthracycline antibiotics)