Pharm110 Chp 30 Musculoskeletal disorder agents

Question 1

Classes of musculoskeletal agents

Answer 1

Centrally acting skeletal muscle relaxants
Direct acting skeletal muscle relaxants
Skeletal muscle stimulants
Neuromuscular blocking agents

Question 2

Back injuries

Answer 2

Types
Sprains (Torn ligaments from sudden injury)
Spasms (Overworked muscles contract involuntarily, so you cannot damage them further)
Ruptured or herniated discs (Squishy center bulges out causing pressure on nerve)
Vertebral fractures (Compression fractures, trauma to vertebra, causes them to crumble)

Question 3

Baclofen, Carisoprodol, Cyclobenzaprine, Methocarbamol

Centrally acting skeletal muscle relaxants

Answer 3

e.g. Baclofen, Carisoprodol, Cyclobenzaprine, Methocarbamol
Action
-Depress CNS in brainstem basal ganglia and neurons of the spinal cord
-Relieve pain with skeletal muscle spasms from sprains, strains, (cerebral palsy)
-Treat arthritis
-Parenteral admin preferred
Adverse effect
-High risk sedation

Question 4

Dantrolene

Direct acting skeletal muscle relaxants

Answer 4

e.g. Dantrolene
Action
-Acts directly on skeletal muscle; relaxes spastic muscle
-Inhibit release of calcium
-Used to treat MS, cerebral palsy and stroke.
-Malignant hyperthermia syndrome
Adverse effect
-Muscle weakness
-Diarrhea, GI upset, photosensitivity, sensory perception, insomnia and depression,
-Hepatotoxicity in females over 35

Question 5

Skeletal muscle stimulants (cholinergic stimulants)

Answer 5

Prefix “tigmine”
e.g. Neostigmine bromide, Neostigmine methysulfate, Pyridostigmine bromide
Action
-Correct muscle weakness such as myasthenia gravis (that destroys Ach receptors)
-Inhibits cholinesterase; more acetylcholine available to cause and maintain muscle contraction
-Work as antagonist to competative neuromuscular blocking agents.
Adverse effects (Caused by unusual cholinergic activity)
-Increased salivation
-Diarrhea
-Intestinal cramping
-Bradycardia
-Miosis

Question 6

Edrophonium

Myasthenia gravis disease agent

Answer 6

Edrophonium (Tensilon, Reversol)
Admin’d parenterally in emergency treatment of myasthenic crises.
All potential myasthenic crisis situations are treated 1st as myasthenic crisis, unless treatment proves crisis is a Cholinergic crisis then Atropine sulfate is administered.

Question 7

Succinylcholine chloride

Neuromuscular blocking agent Depolarizing

Answer 7

Succinylcholine chloride

• Block action of acetylcholine
• Mimic acetylcholine action and prevent cholinesterase from working; muscle becomes overtired and client is unable to use the muscle.
• Only used in ICU and capital punishment
• Eliminate spontaneous breathing, promote mechanical ventilation
• Cause pharmacological restraint, prevent pt. from harming themselves
• Decrease O2 consumption.

No antagonist for this agent, drug must ware off

Question 8

Neuromuscular blocking agent Competative

Answer 8

Prefix “curium”
Action
-Block acetylcholine from attaching to receptors on the motor end plate
-Relax or paralyze the skeletal muscles
-Used for surgery, intubation, Tetanus treatment
Adverse effect
Respiratory paralysis, cardiac collapse or both.
Antagonist
Edrophonium (skeletal muscle stimulant)

Question 9

Ropinirole HCI

RLS

Answer 9

Sensorimotor disorder, distressing urge to move the legs and sometimes other parts of the body usually accompanied by a marked sense of discomfort or pain.
Ropinirole HCI (dopamine receptor agonist) used in RLS treatment.