muscle relaxant handouts

Question 1

spams

Answer 1

sudden, violent, painful, involuntary contractions of a muscle or group of muscles

Question 2

spasticity

Answer 2

increase in the passive stretch resistance of a muscle or muscle group

Question 3

common causes of spasticity

Answer 3

head injury, cerebral palsy, MS, stroke

Question 4

mediator of spasm

Answer 4

lower motor units

Question 5

mediator of spasticity

Answer 5

upper motor units

Question 6

Baclofen can be used to

Answer 6

reduce spasticity associated with MS, spinal cord injury, and cerebral palsy

Question 7

baclofen is not effective against

Answer 7

stroke

Question 8

how does baclofen work

Answer 8

decreases flexor and extensor spasms and suppresses resistance to passive movement

reduction of discomfort and increased performance

Question 9

when is baclofen prefered to dantrolene

Answer 9

in patients who spasticity is associated with significant muscle weakness

Question 10

baclofen does not relieve spasticity of what

Answer 10

parkinson’s disease

Question 11

baclofen pharmacokinetics

Answer 11

good absorption
2-3hrs to reach peak concentration
variable onset of action
T1/2=2.5-4hrs
metabolized in the liver
excreted in the kidney

Question 12

most common side effect of baclofen involve

Answer 12

CNS and Gi tract

Question 13

CNS effects of baclofen

Answer 13

CNS depressant, causes drowsiness, dizziness, weakness and fatigue

Question 14

contraindications of baclofen

Answer 14

patients should be cautioned against use of alcohol and other CNS depressants, since balcofen potentiates the depressant action these drugs

Question 15

diazepam effect

Answer 15

produces sedation in most patients at the doses required to significantly reduce muscle tone

Question 16

doses of diazepam

Answer 16

4mg/dl and gradually increase as far as 60mg/dl

Question 17

diazepam is prefered over

Answer 17

dantrolene in patients whose strength is marginal

Question 18

side effects of diazepam

Answer 18

sedation, to minimize, initiate therapy with low doses

Question 19

what is malignant hyperthermia

Answer 19

a life threatening syndrome that can be triggered by any general anesthetic and by succinylcholine, a NMJ blocking agent

Question 20

symptoms of malignant hyperthermia

Answer 20

muscle rigidity and profound elevation of temperature

Question 21

where does heat from malignant hyperthermia come from

Answer 21

by muscle contraction occurring secondary to massive release of Ca from SR

Question 22

how does dantrolene work

Answer 22

relieve symptoms by acting on SR to block Ca release

Question 23

adverse effects of dantrolene in liver

Answer 23

hepatic damage 1/1000

death can happen if damage is severe

Question 24

side effects of dantaolene in CNS

Answer 24

drowsiness, dizziness, malaise, lightheaded, insomina, fatigue, confusion,

Question 25

side effects of dantrolene in urinary

Answer 25

increased urinary frequency

Question 26

what will increase toxicity of dantrolene

Answer 26

estrogen (hepatotoxicity) CNS depressants (sedation) clindamycin (increased neuromuscular blockade) verapamil (hyperkalemia and cardiac depression) warfarin clofibrate tolbutamine

Question 27

central-acting skeletal muscle relaxants for acute local spasms

Answer 27

Carisoprodol (Soma, Vanadom) Chlorphenesin (Maolate), (anti fungal & anti biotic) Chlorzoxazone (Paraflex, Relaxone) Cyclobenzaprine (Cycloflex, Flexeril) (injury-related spasms) Diazepam (Valium) Metaxalone (Skelaxin) (strains, sprains) Methocarbamol (Carbacol, Robaxin, Skelex) (high risk in elderly) Vigabatrin (Sabril) – a GABA transaminase inhibitor

Question 28

drugs for acute local muscle spasm

Answer 28

Chlorphenesin (contraindicated during pregnancy) Chlorzoxazone Metaxalone Methocarbamol Orphenadrine (anticholinergic properties) Carisoprodol Cyclobenzaprine look at handouts for more lists