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Neuro - Week 1 > Muscle relaxants > Flashcards

Muscle relaxants Flashcards

1
Q

Increased tension in skeletal muscle, often after musculoskeletal injuries and inflammation

A

Muscle spasm

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2
Q

Does muscle spasm or spasticity often occur after injury or inflammation?

A

Spasm

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3
Q

Does muscle spasm or spasticity involve central pathology?

A

Spasticity

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4
Q

Diazepam is this type of drug

A

Benzodiazepine

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5
Q

MOA of diazepam

A

Enhancement of GABA inhibitory actions

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6
Q

Drug for spasms that enhances GABA inhibitory actions

A

Diazepam

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7
Q

Drug that potentiates GABA activity at alpha motor neuron in spinal cord, and causes supraspinal sedation

A

Diazepam

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8
Q

What effect does diazepam have on GABA action?

A

Potentiates GABA activity at alpha motor neuron in spinal cord

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9
Q

What is the half life of diazepam?

A

30-60 hours
(extensive biotransformation)
Metabolite is 30-100 hours (may be greatly increased in elderly)

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10
Q

Benzodiazepine should not be used with these drugs, due to risk of profound sedation, respiratory depression, coma, and death

A

Opiates

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11
Q

Drug for muscle spasms with these adverse effects:
Unsafe during pregnancy and lactation
Tolerance and physical dependence with long-term use
Increased risk of suicidality

A

Diazepam

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12
Q

Is diazepam safe to use during pregnancy and breastfeeding?

A

No

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13
Q

Drug that is an antidote to benzodiazepine overdose

A

Flumazenil

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14
Q

Flumazenil is an antidote to this

A

Benzodiazepine overdose

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15
Q

Drug that specifically binds benzodiazepine binding site and displaces benzodiazepine

A

Flumazenil

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16
Q

Dose low or high dose diazepam treat muscle spasms?

A

Low dose

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17
Q

Dose low or high dose diazepam treat spasticity?

A

High dose

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18
Q

Activation of this increases chloride entry into postsynaptic cells
Action is inhibitory - results in hyperpolarization

A

GABA receptor complex

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19
Q

Type of drugs for muscle spasm that appear to interrupt neuronal communication within the reticular formation and spinal cord to decrease polysynaptic reflex activity
Most cause sedation that contributes to muscle relaxation

A

Polysynaptic inhibitors

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20
Q

Polysynaptic inhibitor that is an absolute contraindication for porphyria

A

Carisoprodol

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21
Q

Polysynaptic inhibitor that has anticholinergic activity noted (dry mouth, blurred vision, constipation, urinary retention, sedation, confusion)

A

Cyclobenzaprine

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22
Q

Polysynaptic inhibitor that is an absolute contraindication for heart problems, concurrent use of monoamine oxidase inhibitors, and hyperthyroidism

A

Cyclobenzaprine

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23
Q

Cyclobenzaprine should not be used concurrently with this type of drugs

A

Monoamine oxidase inhibitors

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24
Q

Polysynaptic inhibitor that is an absolute contraindication in anemia, liver or renal disease

A

Metaxalone

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25
Polysynaptic inhibitor that is not to be used with cyclobenzaprine due to super additive anticholinergic activity
Orphenadrine citrate
26
An adverse effect of this type of drug for muscle spasms is sedation
Polysynaptic inhibitors
27
Carisoprodol is a polysynaptic inhibitor used for muscle spasms that is contraindicated in patients with this condition
Porphyria
28
Cyclobenzaprine is a polysynaptic inhibitor used for muscle spasms that has this type of activity noted, leading to dry mouth, blurred vision, constipation, urinary retention, sedation, confusion
Anticholinergic activity
29
Cyclobenzaprine is a polysynaptic inhibitor used for muscle spasms that is contraindicated in patients with either of these 2 conditions
Heart problems Hyperthyroidism
30
Use of this polysynaptic inhibitor is contraindicated in patients with heart problems or hyperthyroidism
Cyclobenzaprine
31
Metaxalone is a polysynaptic inhibitor used for muscle spasms that is contraindicated in patients with either of these 3 conditions
Anemia, liver or renal disease
32
Orphenadrine citrate is a polysynaptic inhibitor used for muscle spasms that is not to be used with this drug
Cyclobenzaprine due to super additive anticholinergic activity
33
Exaggerated muscle stretch reflex Motor dysfunction secondary to central pathology (e.g. ALS, MS, cerebral palsy) Velocity dependent Supraspinal inhibition/control is reduced/lost secondary to central lesion
Spasticity
34
Spasticity is motor dysfunction secondary to this
Central pathology (e.g. ALS, MS, cerebral palsy)
35
Drug for spasticity that allosterically activates GABA-B receptor to inhibit alpha motor neuron activity in spinal cord
Baclofen
36
What is the MOA of baclofen for spasticity?
Allosteric activation of GABA-B receptor to inhibit alpha motor neuron activity in spinal cord
37
Baclofen allosterically activates this, to inhibit alpha motor neuron activity in spinal cord
GABA-B receptor
38
Baclofen allosterically activates the GABA-B receptor, to inhibit this activity in spinal cord
Alpha motor neuron
39
Drug for spasticity with black box warning against abrupt discontinuation for intrathecal formulation
Baclofen
40
Drug for spasticity where confusion and hallucinations may occur in patients with history of cerebrovascular accidents or elderly
Baclofen
41
This form of baclofen is used in patients with severe, intractable spasticity Tolerance and physical dependence are likely
Intrathecal
42
Tolerance and physical dependence are likely with this form of baclofen
Intrathecal
43
Drug for spasticity that is a direct muscle relaxant Impairs release of calcium from sarcoplasmic reticulum during muscle excitation
Dantrolene sodium
44
Dantrolene sodium impairs release of this from sarcoplasmic reticulum during muscle excitation
Calcium
45
Dantrolene sodium impairs release of calcium from this during muscle excitation
Sarcoplasmic reticulum
46
Drug for spasticity that is also used to treat malignant hyperthermia situations
Dantrolene sodium
47
Dantrolene sodium is a drug for spasticity that is also used to treat this
Malignant hyperthermia situations
48
Drug for spasticity with adverse effects of muscle weakness (includes cardiac and respiratory muscles) and hepatotoxicity
Dantrolene sodium
49
2 adverse effects of Dantrolene sodium
Muscle weakness (includes cardiac and respiratory muscles) Hepatotoxicity
50
Drug for spasticity that is an absolute contraindication for liver disease
Dantrolene sodium
51
Dantrolene sodium is an absolute contraindication for patients with this
Liver disease
52
Adverse effects of this nerve terminal calcium modifier includes increased risk of suicide, tolerance and physical dependence
Gabapentin
53
Gabapentin may be used for spasticity and has adverse effects of increased risk of these 3 things
Suicide, tolerance, and physical dependence
54
Drug for spasticity that is a centrally acting ɑ2 adrenergic receptor agonist
Tizanidine
55
Tizanidine is a centrally acting agonist of this receptor
ɑ2 adrenergic receptor
56
Activation of this receptor by Tizanidine increases presynaptic inhibition of motor neurons
ɑ2 adrenergic receptor
57
Drug for spasticity with possible actions on blood pressure (hypotension) and heart rate (bradycardia)
Tizanidine
58
2 adverse effects of Tizanidine
Hypotension, Bradycardia
59
Activation of ɑ2 adrenergic receptor by this drug for spasticity increases presynaptic inhibition of motor neurons
Tizanidine
60
How does Tizanidine treat spasticity?
Is a centrally acting ɑ2 adrenergic receptor agonist Activation increases presynaptic inhibition of motor neurons
61
How do Botulinum toxins treat spasticity?
Inhibit acetylcholine release at neuromuscular junction
62
Botulinum toxins inhibit release of this at neuromuscular junction
Acetylcholine
63
Botulinum toxins can be used for spasticity by acting on this
Neuromuscular junction (prevent acetylcholine release)
64
What is the black box warning of Botulinum toxins?
Distant spread of toxin from site of injection
65
Diazepam is used to treat this
Spasms
66
Polysynaptic inhibitors are used to treat this
spasms
67
Baclofen is the firstline treatment for this
Spasticity
68
What is the firstline treatment for spasticity?
Baclofen
69
Dantrolene sodium is mainly used to treat this
Spasticity
70
Botulinum toxins can be used to treat this
spasticity
71
Gabapentin and Tizanidine can be used to treat this
Spasticity

Neuro - Week 1 (10 decks)

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