Muscle Relaxants

Question 1

Describe the MOA, use, and ADRs of baclofen?

Answer 1

MOA - Binds GABA-B causing increased K conductance and decreased Ca conductance

Use - muscle relaxants; less sedatory than diazepam and less muscle weakness than dantrolene

ADRs - drowziness and other alterations to mental status; ataxia

Question 2

Describe the MOA, use, and ADRs of Tizanidine?

Answer 2

MOA - Binds alpha-2 agonistically

Uses - muscle spasm; comparable efficacy with other agens

ADRs - drowziness, dizziness, and hypotension

Question 3

Describe the MOA, use, and ADRs of diazepam?

Answer 3

MOA - Activates GABA-A

Uses - sedation, hypnosis, muscle relaxation, and anxiolysis

ADRs - sedation and risk of dependence

Question 4

Describe the MOA, use, and ADRs of carisoprodol?

Answer 4

MOA - unclear; CNS depressant

Use - Local muscle spasms

ADRs - drowziness, dizziness, and addiciton

Note: Metabolite meprobromate is anxiolytic

Question 5

Describe the MOA, use, and ADRs of cyclobenzaprine?

Answer 5

MOA - reduces somatic motor tonicity through alpha and gamma motor neurons

Use - Painful and acute muscle spasms

ADRs - Antimuscarinic and sedation/confusion (similar to tricyclics)

Question 6

Describe the MOA, use, and ADRs of dantrolene?

Answer 6

MOA - inhibits RyR

Use - Spasms of UMN disease; Malignant hyperthermia

ADRs - dizziness, sedation, and hepatitis

Question 7

Describe the MOA, use, and ADRs of Botulinum Toxin?

Answer 7

MOA - zinc endopeptidase cleaves proteins required for vesicular fusion

Use - cervical dystonia; facial wrinkles; primary axilary hyperhidrosis; incontinence d/t overactive bladder

ADR - local muscle weakness up to months

Question 8

Name the drugs used for Multiple Sclerosis?

Answer 8

Interferon-Beta, Glatiramer Acetate, Mitoxantrone, and Corticoids

Question 9

Describe the MOA, uses, and ADRs of Interferon-Beta-1a/b

Answer 9

MOA - Enhance suppressor T cell activity, decrease antigen presentation, decrease leaukocyte entrance into CNS

uses - improves MRI lesions and reduces relapses

ADRs - Injection site reactions, flu-like symptoms, leukocytopenia, anemia, and suicide

Question 10

Describe the MOA, uses, and ADRs of Glatiramer Acetate.

Answer 10

MOA - random polymers of four amino acids (alanine, glutamate, lysine, tyrosine)

uses - relapsing-remitting MS

ADRs - post-injection reactions (local site, chest pain, flushing, anxiety)

Question 11

Describe the MOA, uses and ADRs of Mitoxantrone.

Answer 11

MOA - intercalates DNA causing cross-linking and strand breaks

Uses - refractory MS, AML, advanced/refractory prostate cancer

Question 12

When are corticoids used for the treatment of MS?

Answer 12

Primary and secondary progressive forms