Muscle Relaxants Flashcards
cyclobenzaprine MOA
skeletal muscle relaxant that works at the brainstem level
cyclobenzaprine pharmacokinetics
metabolized by CYP3A4, 1A2, and 2D6
indication cyclobenzaprine
addition to rest and PT for muscle spasm from acute painful musculoskeletal conditions
drug interactions cyclobenzaprine
MAOI - fatal
alcohol and other depressants - careful
Tramadol - seizure risk
cyclobenzaprine warnings
urinary retention and acute angle closure glaucoma
increased intraocular pressure due to anticholinergic effects
Carisoprodol is metabolized to ___
meprobamate in the liver
meprobamate tends to…
accumulate in the body more and.. is renally excreted
ADR of carisoprodrol
transient quadriplegia - fairly rare,
CNS depression etc
Metaxalone MOA
not well known works and indicated for same stuff as carisprodrol
unique ADR of metaxalone
leukopenia, hemolytic anemia, jaundice
baclofen MOA
inhibits spinal reflex
baclofen indication
MS, TGN, and spinal cord injury
chronic hiccups and cancer pain - off label
may also treat addicitons (opiod, cocaine, etOH)
orphenadrine indications and ADR
analgesic, anticholinergic:
dry mouth, tachycardia, urinary retention etc
Chlorozoxazone acts on what part of CNS
spinal cord and subcortical brain areas
is chlorozoxazone well tolerated?
yes
what is chlorzoxazone associated with?
idiosyncratic hepatotoxicity
- get baseline LFT before prescribing this
what is glucosamine sulfate?
amino sugar used for synthesis for mucopolysaccharides - part of cartilage proteoglycans
found in tendons, cartilage, ligaments, synovial fluid
how does glucosamine sulfate work?
stimulates metabolism of chondrocytes
may modify OA process and HIV?
long term uses for glucosamine sulfate
decreased OA progression
decresed risk for total knee replacement
what is the one possible ADR of glucosamine sulfate?
may impact insulin resistance
Intrathecal options
ziconotide
baclofen
ziconotide is a ___ antagonist
N type calcium channel blocker in the primary nociceptive afferent nerves in the dorsal horn
but no effect on opiod receptors
ziconotide is isolated from
marine snail
3 warning ziconotide
Neuropsychiatric ADR
CI: pts with history of psychosis
Monitor for: cognitive impairment, hallucinations, mood change etc.
ADR of ziconotide
dizzy, ataxia, somnolence, nausea, confusion, asthenia, abnormal gait etc.
___ is used for severe muscle spasiticy
intrathecal baclofen
give one dose prior to starting pump
ADR of intrathecal baclofen
hypotonia, somnolence, dizzy
intrathecal baclofen must be___
tapered off
when is menthol used?
orally for GI complaints
