Neuromuscular Disorders

Question 1

What characterises myasthenia gravis?

Answer 1

Muscle weakness

Question 2

What is quinine used for?

Answer 2

Nocturnal leg cramps

Question 3

When is quinine used?

Answer 3

Sleep regularly disturbed
Cramps painful or frequent
Treatable causes excluded
Non-pharmacological treatments not worked

Question 4

What are the side effects of quinine?

Answer 4

QT prolongation
Convulsions
Arrhythmias
Toxic in overdose

Question 5

What is the MHRA warning for quinine?

Answer 5

Dose dependent QT prolonging side effects

Question 6

How often do you monitor quinine?

Answer 6

Every 3 months interrupt treatment to assess further need

Question 7

What is baclofen used for?

Answer 7

Chronic severe spasticity

Question 8

What is the mechanism of action of baclofen?

Answer 8

GABA analogue

Works at spinal level and depresses CNS

Question 9

What are the side effects of baclofen?

Answer 9

Drowsiness

Muscular hypotonia

Question 10

What are the cautions for baclofen?

Answer 10

Drowsiness may affect driving

Withdrawal reactions

Intrathecal use - test dose, closely monitor, resuscitation immediately available and initiate within 3 months of test dose