muscle relaxants Flashcards
cyclobenzaprine brands
Flexeril
Amrix
flexeril
amrix
generic
cyclobenzaprine
cyclobenzaprine MOA
skeletal muscle relaxant (antispasmodic)
- works at brainstem level
- anticholinergic activity
- potentiates NE
how is flexeril cyclobenzaprine cleared?
renal drug
t/f flexeril effective in spasticity due to spinal cord or cerebral injury, cerebral palsy, ?
no not effective
cyclobenzaprine ADR
- think anticholinergic effects
- dry mouth
HA
somnolence
flexeril, amrix drug interactions
- MAOI: fatal interaction
- ETOH other depressants
- increase risk sz with tramadol!!
warnings cyclobenzaprine
- urinary retention
- increases IOP (acute angle closure glaucoma)
who concerned increased IOP with cyclobenzaprine
those at risk for acute angle closure glaucoma
- farsighted hyperopes
- women
- asian
- older
carisoprodol (Soma) is a muscle relaxant however don’t rx because
high abuse potential
MOA not fully understood
rare ADR: transient quadriplegia
metaxalone (skelaxin) MOA
not well known
- CNS depression
- no direct muscle effect
metaxalone ADR
N/V GI upset
leukopenia
hemolytic anemia
jaundice
methocarbamol brand
robaxin
baclofen brands
kemstro, lioresal, gablofen
baclofen MOA
GABA analog
inhibits reflexes at spinal level
___ is indicated for spasms due to multiple sclerosis, trigeminal neuralgia, spinal cord injury
baclofen (kemstro, gablofen, lioresal)
baclofen potential helps ___
treat addiction
- opioid
- cocaine
- ETOH
orphenadrine brand
norflex
norgesic
orphenadrine moA
analgesic
anticholinergic
(ADR: blurr vision, mydriasis, increased weakness, N/V etc)
chlorzoxazone brands
parafon forte
lorzone
chlorzoxazone MOA
inhibits multisynaptic reflex arcs that produce spasms
- relieves pain, increase mobility
chlorzoxZONE VS ORPHENADRINE
chlorzoxazone is less anticholinergic
better well tolerated
what lab get prior to start on chlorzoxazone
LFT
can cause idiosyncratic hepatotoxicity
what is glucosamine sulfate
works well with horse RA
-
MOA glucosamine sulfate
amino sugar that is part of cartilage proteoglycans, found in tendons, cartilage, ligaments, synovial fluid etc
- stimulates metabolism of chondrycytes in articular cartilage
- improves pain and function
what warning with glucosamine hydrochloride
make sure pt does not have shellfish allergy as it comes from seashells
topical methyl salicylate (wintergreen oil) topical pain relief worry about
ASA allergy
watch with anticoagulants
short term use no longer than 1 week
how does topical capsaicin work
- counter irritant
- creates local irritation/ inflammation to relieve inflammation in underlying or adjacent tissues
menthol is active ingredient in
peppermint
menthol uses
- orally for GI complaints
- antispasmodic for IBS
- relaxes LES
- lower GI motility
- topically for pain
ADR: heartburn, N/V, contact dermatitis
menthol rub abuse
- applying to eye
- huffing vicks vapor rub etc
camphor is what
topical antitussive / analgesic
- can cause resp failure, sz
post-herpetic neuralgia topical recommended
capsaicin
- stimulates TRPV1 which stimulates pain receptors and brings relief to area depletes substance P
