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Clin Med Final > Pharmacology- Muscle Relaxants > Flashcards

Pharmacology- Muscle Relaxants Flashcards

1
Q

Skeletal muscle relaxants ( bright teal)

General classes of drugs based on _______ _______

Those used to reduce _______ ______

___________

muscle _________

A

therapeutic use

muscle excitbaility

spasticity

spasm

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2
Q

Skeletal muscle relaxants

Goal is to reduce ________ ______ without limiting _______ _______

A

muscle spasticity
muscle function

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3
Q

Spasticity (hypertone)- RED

Occurs after a _________ injury or _________

Due to an exaggerated muscle ______ _______

Is ________ dependent

Usually an _________ muscle (ex. biceps)

A

CNS; disease
stretch flex
velocity
antigravity

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4
Q

Spasms- yellow

Increased muscle ________ following ______ or ________

Due to an ________ injury

____genic (does have a ______ component)

_________, _________

A

tension; injury; inflammation

orthopedic

myo; neuro

continuous; tonic

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5
Q

(RED) Hyertone develops when there is ….

decrease in _________ from _______ and inhibitory ______ inter_______

Following an ______ lesion
_______- velocity dep hypertone , on the against _______ mm. side of a joint

A

inhibition; cortex
SC; neurons

UMN
Spatisicty; antigravity

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6
Q

( YELLOW ) Muscle Spasm develops due to:

_________ imbalance
________
MM. _______
MM. _________

Has both a ____genic and _____genic compenents if prolonged

A

Electrolyte
Dehydration
strain
overuse

myo; neuro

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7
Q

Muscle Relaxants for Hypertonicity (RED) or Spasms (YELLOW)

__________ - primarily used for hypertone (RED)

_______- poly synaptic inhibitor (within spinal cord) (hot pink)

_______- poly synaptic inhibitor AND central acting (hot pink)

________- acts directly on muscle (YELLOW)

______ - acts as the NMJ (RED)

A

Baclofen

Tizanidine

Diazepam

Dantrolene

Botox

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8
Q

Polysnaptic Inhibitors (hot pink)

_______ acting

Mechanism of action is _______ understood

Can cause a general reduction in ______ activity (may be reason the mm. relax)

Commonly used agents

__________

__________

___________

A

Centrally

poorly

CNS

Diazepam

Carisoprodol

Metocarbamol

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9
Q

_________ (RED)

is a GABA-B agonist

+ hyperpolarization

decreases release of excitatory NT

increases neuronal inhibition

A

Baclofen

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10
Q

Baclofen Intrathecal Administration

The Programmer (RED)

Externally programmed via ________ _______

Instructions transmitted through a “_____” by radio telemetry to the infusion ______

Can be programmed for a _______ dose over _____ hours and up to ____ specific dosages through the day

\_\_\_\_\_\_\_\_ continuous
 periodic \_\_\_\_\_\_\_\_
 Complex- \_\_\_\_\_\_\_\_\_\_
  Avg doses- \_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_mcg
  Refill every \_\_\_-\_\_\_\_\_ weeks
A

computer software

wand

pump

continuous
24
12
simple
bolus
continuous
300; 1000
4; 12

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11
Q

Baclofen Intrathecal Administration

The PUMP (bright green)

Surgically _______ SC in the _______

______ and ______ prescribed amt. of drugs

Holds ____ml

Refilled every q ____-______ months, depends on pump _____, _____, and _______

A

implanted; abdomen

Stores; releases

18

1; 5

size, concentration, dose

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12
Q

Baclofen Intrathecal Administration

The Catheter (BLUE)

Small diameter, silicone ______ ______

Travels from _____, under skin, to _______ site in spinal cord

Catheter introduced below ______
and advanced to ____-_____

A

rubber tube

pump
delivery

L3

T8-T10

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13
Q

Intrathecal Pump

Disadvantages (RED)

  1. Requires _______ to implant the pump
  2. _______
  3. Tubing can become _____ or _______
  4. Risks
    a. _______
    b. Balclofen ______
    c. Pump _______
    d. Symptoms of ______
A

surgery

expensive

disconnected; kinked

infection

overdose

dysfunction

withdrawl

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14
Q

Intrathecal Pump

Advantages (bright GREEN)

  1. Medicine is sent directly to ________ ________
  2. Medicine _______ can be _______
  3. Less _______ needed = reduces ______ _____
  4. Can be easily ________
  5. Surgery is _________
A

nerve cells

dosage; adjusted

medicine; side effects

refilled

reversible

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15
Q

S/S of Intrathecal Pump Overdose

  1. S_____
  2. S______
  3. H______
  4. D_____
  5. R_______ D______
  6. _______ of _______
A

Somnolence
Seizures
Hypertonia
Drowsiness
Respiratory Distress
Loss of consciousness

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16
Q

Intrathecal Baclofen Candidates (RED)

Moderate to severe _________

Potential to be more ________ with ADL’s

_____-________ with _____ interfering with caregiving

Pain or at risk for _______ deformity

Over ____ years old

Respond to intrathecal test dose < ____ micrograms

One year post _____

A

hypertonicity

independent

non; ambulatory; tone

skeletal

4

100

TBI

17
Q

________

Increased GABA’s central inhibit effect

CNS depressant

A

Diazepem

18
Q

_________ (_ ________ )

Acts directly on mm.

An antagonist of the ryanodine receptor (Ca channel receptor) in SR of skeletal mm.

A

Dantrolene (Dantrium)

19
Q

_________ ( __________ ) (within spinal cord)

central acting -2 agonist

increased inhibit effects

A

Zanaflex (Tizanidine)

20
Q

___________ ________
Prevents release of acetylocholine vesicles from presynaptic axon @ NMJ

Toxin binds to presynaptic axon terminal

Internalization of toxin

Inhibition of NT release

Administered IM in specifc mm.

Chemical denervation within days last approx 3 months

A

Botulinum Toxin (BOTOX)

21
Q

Carisoprodol (SOMA) - hot pink

Onset: ____ mins

Duration: ___ -___ hrs

A

30
4; 6

22
Q

Chlrozoxazone (Paraflex, Parafon Forte) -hot pink

Onset: within ______ mins
Duration: ___-____ hrs

A

60
3; 4

23
Q

Cyclobenzaprine (Flexeril) - hot pink

Onset: within ____ mins
Duration: ___-____ hrs

A

60
12; 24

24
Q

Diazepam (Valium)- hot pink

Onset: ___-____ mins
Duration: ________

A

15; 45
variable

25
Q

Metaxalone (Skelaxin)- hot pink

Onset: ______ mins
Duration: ___-____ hrs

A

60
4; 6

26
Q

Methocarbamol (Carabot, Robaxin)- hot pink

Onset: within _____ mins
Duration: _____ hrs

A

30
24

27
Q

Orphenadrine citrate (Antiflex, Norflex)- hot pink

Onset: within ______ mins
Duration: _____ hrs

A

60
12

28
Q

Adverse Reactions (ORANGE)

Generalized _______ ______
Decreased ______ _____
S_______
D_______
A_______

A

muscle weakness
muscle tone
sedation
dizziness
ataxia

29
Q

Effets interfering with rehabilitation (light GREEN)

________ ________ problems
Functional ________
Decreased ________
W_______
_________ and ________ dependence

A

Motor control
decline
alertness
weakness
Tolerance; physical

30
Q

Muscle Relaxers Side Effects

C_______
D________
Low ______ ______
Dry ________
_________ reactions
_______ gain
Impaired __________
________ problems

A

Constipation
Dizziness
Blood Pressure
Mouth
Allergic
Weight
thinking
Heart

Clin Med Final (1 decks)

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