Muscle Relaxants

Question 1

Zanaflex

• Indication
• MOA
• Dose
• SEs

Answer 1

Tizanidine

• Indication: muscle relaxant
• MOA: Alpha-2 agonists structurally similar to clonidine
• Dose: start 4mg. Max 36mg

SEs

• HypoTN, hepatotoxicity
• Hallucination, Sedation, dizziness
• Dry mouth (anticholinergic)

Question 2

Flexeril

• Indication
• Dose
• Avoid

Answer 2

Cyclobenzaprine

• Indication: muscle relaxant
• Structurally related to amitriptyline: anticholinergic ADEs
• Dose: 5mg TID. Max 10mg TID for 2-3 wks
  Amrix: QD
• Avoid in mod to severe hepatic imp

Question 3

Soma

• Indication
• CS:
• Dose
• Administration instruction
• Caution/Avoid

Answer 3

Carisoprodol

• Indication: muscle relaxant
• CS: Schedule IV
• Dose: up to 250-350mg QID with MEALS for 2-3wks

Cautions:

• Hepatic and renal insufficiency
• Abuse potential
• Sedative effects can result in imp driving

Question 4

Dantrium

• MOA
• Indication
• Dose
• C/I

Answer 4

Dantrolene

• MOA: interfere w/ Ca+2 channel
• Indication: spasticity, malignant hyperthermia
• CI: hepatic disease
• Spasticity: start 25mg QD to 100 mg QID. Max 400mg/d
• Malignant hyperthermia: 2.5mg/kg rapid IV push Q5-10min

Question 5

Lioresal

• Indication
• MOA
• Frequency

Answer 5

Baclofen

• Indication: spasticity related to MS or spinal cord injury/disease
• MOA: inhibits spinal reflexes
• Dose: start 5mg TID. Max 20mg QID

Question 6

Roxabin

• Indication
• Dosage form
• Frequency
• Urine color:

Answer 6

Methocarbamol

• Indication: musculoskeletal pain
• Dosage form: PO, IV, IM.
  MD: 1000mg QID or 750mg Q4H for 1500 TID
• Caution: urine discoloration (brown, brown-black or green)

Question 7

Skelaxin

• Indication
• Frequency
• CI

Answer 7

Metaxalone

• Indication: musculoskeletal pain
• Dose: 800mg TID-QID
• CI: liver/renal impairment
• Hypersensitivity rxn

Question 8

Parafon Forte DSC

• Indication
• Frequency
• D/C if:
• Color of urine:

Answer 8

Chlorzoxazone

• Indication: musculoskeletal pain
• Starting dose: 250-500mg TID/QID. Max 750mg QID

D/C if:

• Allergic rxn occurs
• Symptom of liver dysfunction occur
• Urine discoloration (orange or purple red)

Question 9

Amrix

• Indication
• Form
• Dose/frequency
• Caution

Answer 9

Cyclobenzaprine ER

• Indication: muscle relaxant
• Structurally related to amitriptyline: anticholinergic ADEs
• Dose: 15-30mg QD for 2-3 wks
• Caution: avoid in mod to severe hepatic imp