Neuromuscular Disorders Flashcards
What is myasthenia gravis?
Myasthenia gravis is an autoimmune condition leading to skeletal muscle weakness. It most commonly affects the muscles that control the eyes and eyelids, facial expressions, chewing, swallowing and speaking. But it can affect most parts of the body.
What are the symptoms of myasthenia gravis?
Droopy eyelids, double vision, difficulty making facial expressions, problems chewing and difficulties swallowing, slurred speech, weak arms, legs, or neck, SOB and occasional serious breathing difficulties.
Which medications are used in the treatment of myasthenia gravis?
Anticholinesterases (physostigmine and neostigmine), immunosuppressants, corticosteroids.
Which skeletal muscle relaxants are licensed for the relief of chronic muscle spasms or spasticity associated with multiple sclerosis or other neurological damage?
Baclofen, diazepam, tizanidine.
What is the method of action of baclofen?
Researchers don’t know exactly how baclofen works; however, in general, it blocks nerve signals from muscles at the level of the spinal cord and it may also depress the central nervous system.
How is baclofen administered?
Orally or intrathecally (by injection into the spinal cord).
When should caution be taken when administering baclofen intrathecally?
Coagulation disorders, previous spinal fusion procedure, malnutrition (increased risk of post-surgical complications).
Baclofen is administered by an implanted intrathecal pump. When should this pump be implanted?
Pump initiation should be initiated within three months of satisfactory response to intrathecal baclofen testing.
It is important to monitor patients closely during screening and immediately after implantation of an intrathecal pump for baclofen administration. What facilities should be on hand at all times?
Resuscitation facilities.
How should baclofen treatment cessation be carried out?
Abrupt withdrawal should be avoided. Treatment should be discontinued by gradual dose reduction over at least 1-2 weeks.
What are the symptoms a patient may experience if baclofen treatment is withdrawn abruptly?
Hyperactivity state, exacerbation of spasticity, psychiatric reactions.
What important side effect of baclofen should patients be made aware of?
Baclofen can cause drowsiness which may affect the performance of skilled tasks such as driving. This is enhanced by alcohol consumption.
