Neuro part 3

Question 1

What causes spasticity

Answer 1

Lesion along path of corticospinal tracts 🡪 overactive alpha motor neuron (in the SC)
Imbalance between afferent ascending excitatory pathway and descending inhibitory pathway

Question 2

tizanidine (Zanaflex) Class, MOA, AE

Answer 2

MOA: selectively bind α2 receptors in CNS to ↓ release of excitatory neurotransmitters from presynaptic terminals and ↓ excitability of postsynaptic neurons

AE: drowsiness, dizziness, hypotnesion

Question 3

Cyclobenzaprine (Flexeril)- class, AE

Answer 3

Centrally Acting Antispasmodics

Most common AE: sedation, dizziness

Question 4

Botulinum toxin

Answer 4

MOA: blocks release of ACh into the NM junction
Can spread to other tissues and be fatal
**especially if it reaches the lungs

Question 5

Baclofen class, MOA,

Answer 5

inhibitory effect on alpha motor neuron through inhibition of excitatory neurons (i.e., reduced spasticity)

Question 6

Box warning for Baclofen

Answer 6

: Abruptly stopping medication can lead to:
High fever
AMS
Exaggerated rebound spasticity and muscle rigid
Rare cases of rhabdomyolysis and organ-system failure

Question 7

Baclofen AE

Answer 7

CNS depressant (sedation, ataxia, cardiac/respiratory depression), muscle weakness, in older adult and TBI- impaired memory and cognition

Question 8

Baclofen ITB refill

Answer 8

refill every 3 months

replace battery every 4-5 yr

Question 9

Antispasticity/Muscle Relaxant Drug Concerns

Answer 9

Sedation and weakness most notable impact on patient participation in PT
Also with a reduction in muscle tone we may see decreased force output when working out