Other Neurological conditions

Question 1

Baclofen (Stelax OR Clofen)

Answer 1

A) Muscle Relaxant

B)

1. Chronic spasticity associated with MS and Spinal cord lesions
2. Chronic spasticity of Cerebral origins (intrathecal)

C)
5 - 25 mg TDS
Max: 150 mg daily (in hospital)

D)

1. WITHDRAWAL SYNDROME (anxiety, altered mental state, seizures, high fever and rebound spasticity)
2. CLINICAL EFFECT and DURATION (stop if no benefit within 6-8 weeks)
3. BLOOD GLUCOSE (increased)
4. RENAL (primary - reduce dose)
5. HEPATIC (increased S/E)

E)
Labels: 1, 9, B (with FOOD - to minimise stomach upset)
#Avoid drinking ALCOHOL - worsen S/E
S/E:
*GIT (nausea and vomiting, constipation, diarrhoea)
*MOTOR (respiratory depression, muscular weakness, myalgia)
*CNS (drowsiness, dizziness, headache, insomnia, confusion)

Question 2

Dantrolene (Dantrium)

Answer 2

A) Muscle relaxant

B)

1. CHRONIC SPASTICITY associated with:
   - spinal cord injury
   - head injury
   - MS
   - cerebral palsy
   - stroke
2. MALIGNANT HYPERTHERMIA (IV)

C)
25 - 400 mg daily (in divided doses)

D)
1. Severe DIARRHOEA (stop tx)
2. DURATION of tx (stop within 6-7 weeks of no effect)
3. HEPATIC (increased risk of hepatotoxicity)
NO renal

E)
Labels: 1, 8
#May cause drowsiness, dizziness or affect your VISION; if affected, do not drive
#May initially cause tiredness, dizziness, weakness and diarrhoea. Decreases with continued use.
**DR - (hepatic) yellow skin or eyes, dark urine, itchy skin or nausea or vomiting

Question 3

Modafinil (Modavigil)

Answer 3

A) Non-Amphetamine Psychostimulant

B)

1. Narcolepsy
2. Excessive Sleepiness (chronic shift-work sleep disorder)
3. Continuous Positive Airway Pressure [CPAP] (adjunct) in [OSA] Obstructive Sleep Apnoea syndrome

C)
100 - 400 mg daily (1 or 2 doses)

D)
1. BLOOD PRESSURE (hypertension)
2. HEART RATE
3. Drug MISUSE or ABUSE
4. MOOD (increased risk of suicidality)
5. Oral contraceptive (reduced)
6. Rash
7. HEPATIC (reduce dose)
NO renal

E)
Labels: 12
#If taking twice a day, take the 2nd dose no later than midday
**DR - Rash
S/E
GIT (nausea, diarrhoea, anorexia)
CNS (headache)
MOOD (anxiety, nervousness, depression)
CARDIO (hypertension, tachycardia, palpitations

Question 4

Riluzole (Rilutek)

Answer 4

A) Glutamate neurotransmission inhibitor

B)
1. Amyotrophic lateral sclerosis

C)
50 mg TWICE daily

D)

1. HEPATIC (contraindicated - increased aminotransferase)
2. Complete blood count (neutropenia)

E)
Labels: 12, C (at least 1 hr before or 2 hrs after food)
*DR - develop a FEVER