Muscle Relaxants

Question 1

cyclobenzaprine MOA

Answer 1

skeletal muscle relaxant that works at the brainstem level

Question 2

cyclobenzaprine pharmacokinetics

Answer 2

metabolized by CYP3A4, 1A2, and 2D6

Question 3

indication cyclobenzaprine

Answer 3

addition to rest and PT for muscle spasm from acute painful musculoskeletal conditions

Question 4

drug interactions cyclobenzaprine

Answer 4

MAOI - fatal
alcohol and other depressants - careful
Tramadol - seizure risk

Question 5

cyclobenzaprine warnings

Answer 5

urinary retention and acute angle closure glaucoma

increased intraocular pressure due to anticholinergic effects

Question 6

Carisoprodol is metabolized to ___

Answer 6

meprobamate in the liver

Question 7

meprobamate tends to…

Answer 7

accumulate in the body more and.. is renally excreted

Question 8

ADR of carisoprodrol

Answer 8

transient quadriplegia - fairly rare,

CNS depression etc

Question 9

Metaxalone MOA

Answer 9

not well known works and indicated for same stuff as carisprodrol

Question 10

unique ADR of metaxalone

Answer 10

leukopenia, hemolytic anemia, jaundice

Question 11

baclofen MOA

Answer 11

inhibits spinal reflex

Question 12

baclofen indication

Answer 12

MS, TGN, and spinal cord injury
chronic hiccups and cancer pain - off label
may also treat addicitons (opiod, cocaine, etOH)

Question 13

orphenadrine indications and ADR

Answer 13

analgesic, anticholinergic:

dry mouth, tachycardia, urinary retention etc

Question 14

Chlorozoxazone acts on what part of CNS

Answer 14

spinal cord and subcortical brain areas

Question 15

is chlorozoxazone well tolerated?

Answer 15

yes

Question 16

what is chlorzoxazone associated with?

Answer 16

idiosyncratic hepatotoxicity

- get baseline LFT before prescribing this

Question 17

what is glucosamine sulfate?

Answer 17

amino sugar used for synthesis for mucopolysaccharides - part of cartilage proteoglycans
found in tendons, cartilage, ligaments, synovial fluid

Question 18

how does glucosamine sulfate work?

Answer 18

stimulates metabolism of chondrocytes

may modify OA process and HIV?

Question 19

long term uses for glucosamine sulfate

Answer 19

decreased OA progression

decresed risk for total knee replacement

Question 20

what is the one possible ADR of glucosamine sulfate?

Answer 20

may impact insulin resistance

Question 21

Intrathecal options

Answer 21

ziconotide

baclofen

Question 22

ziconotide is a ___ antagonist

Answer 22

N type calcium channel blocker in the primary nociceptive afferent nerves in the dorsal horn

but no effect on opiod receptors

Question 23

ziconotide is isolated from

Answer 23

marine snail

Question 24

3 warning ziconotide

Answer 24

Neuropsychiatric ADR
CI: pts with history of psychosis
Monitor for: cognitive impairment, hallucinations, mood change etc.

Question 25

ADR of ziconotide

Answer 25

dizzy, ataxia, somnolence, nausea, confusion, asthenia, abnormal gait etc.

Question 26

___ is used for severe muscle spasiticy

Answer 26

intrathecal baclofen

give one dose prior to starting pump

Question 27

ADR of intrathecal baclofen

Answer 27

hypotonia, somnolence, dizzy

Question 28

intrathecal baclofen must be___

Answer 28

tapered off

Question 29

when is menthol used?

Answer 29

orally for GI complaints