NMS

Question 1

Anti-Spasticity Agents

Answer 1

Action: typically from injury to CNS, agents blind selectively within the CNS or MSK to reduce spasticity

Indication: increased tone, spasticity, SCI, CVA, MS

Side Effects: drowsy, confusion, HA, dizzy, gen ms wk, hepatotoxicity (dantrium), tolerance, dependence

Implications for PT: balance need to decrease spasticity w/ loss of fxn, focus on facilitation, strength etc

Examples:

• lioresal (baclofen)
• valium (diazepam)
• dantrium (dantrolene)
• zanaflex (tizanidine)

Question 2

Muscle Relaxant Agents:

Answer 2

Action: promote relaxation in ms w/ spasm - continuous, tonic. typically MSK or peripheral nerve

Indication: ms spasm

Side Effects: sedation, drowsiness, dizziness, nausea, vomiting, HA, tolerance, dependence

Implications for PT: use of modalities, prevent re-inju

Examples:

• valium (diazepam)
• flexeril (cyclobenzaprine)
• paraflex (chlorzoxazone)

Question 3

Antiepileptic Agents

Answer 3

Action: inhibit firing of certain cerebral neurons via effects on CNS. include: barbituates, benzos, carboxylic acids, hydantoins, iminostilbenes, succinimides, 2nd generation drugs

Indication: seizure activity

Side Effects: ataxia, skin issues, behavoir, GI, HA, blurred vision, weight gain

Implications for PT: greater sensitivity to light/sound

Examples:

• seconal (secobarbitol)
• klonopin (clonazepam)
• depakote (valproic acid)
• dilantin (phenytoin)
• tegretol (carbamazepine)
• celontin (methsuximide)
• neurontin (gabapentin)

Question 4

Dopamine Replacement Agents:

(NMS)

Answer 4

Action: assist to relieve sx of PD 2ndary to the decrease in endogenous dopamine. Cross blood brain barrier through active transport and transform DA

Indication: PD, parkinsonism

Side Effects: (levodopa) arrhythmias, GI distress, orthostatic hypotension, mood/behavior, tolerance

Implications for PT: schedule 1 hr after, drug holidays

Examples:

• sinemet or madopar (levodopa)
• symmetral (amantadine)