Skeletal Muscle Relaxants Flashcards
1
Q
Antispasticity Agents (4)
A
- Baclofen
- Tizanidine
- Dantrolene
- Diazepem
2
Q
Antispasmodics (8)
A
- Tizanidine
- Benzos
- Methocarbamol
- Cyclobenzaprine
- Carisoprodol
- Orphenadrine
- Metaxalone
- Chlorzoxazone
3
Q
Baclofen
4 important things
9 ADRs
A
- GABA(b) mimetic
- PO or intrathecal (helpful in controlling severe spasticity and pain in patients not responsive to other meds)
- Inhibits release of substance P
- For spinal spasticity, MS
- ADRs: drowsiness, may decrease seizure control in epileptics, impairs motor coordination, nausea, vertigo, hypotonia, weakness, depression, headache
4
Q
Botulinum Toxin
3 important things
A
- IM injection
- Blocks pre-synaptic release of ACh from nerve terminal
- For strabismus, blepharospasm, stroke spasticity
5
Q
Carisoprodol
4 important things
8 ADRs
A
- PO tablet
- For relief of spasm, acute musculoskeletal pain relief
- NOT effective for chronic condition
- Schedule IV
- ADRs: drowsiness, increased HR, flushing, CNS depression, trembling, headache, angioedema, hiccups
6
Q
Chlorzoxazone
3 important things
3 ADRs
A
- PO, take with food or milk (GI irritant)
- For rapid relief
- Superior to diazepam
- ADRs: hepatocellular toxicity (monitor fatigue, anorexia, N/V, rash, jaundice, dark urine)**, drowsiness, similar to carisoprodol
7
Q
Clonidine
2 important things
7 ADRs
A
- Adjunct, rarely used
- a-Agonist (decreases sympathetic outflow)
- ADRs: bradycardia, hypotension, dry mouth, constipation, drowsiness, dizziness, depression
8
Q
Cyclobenzaprine
4 important things
6 ADRs
A
- Related to TCA
- For trauma, acute musculoskeletal pain, spasm, local pain, and ROM
- As effective or better than diazepam
- Long DOA
- ADRs: dry mouth, edema of face/lips, syncope, blurred vision, muscle weakness, urination problems
9
Q
Dantrolene
3 important things
2 ADRs
A
- Chemically unique
- Interferes directly with excitation-contraction coupling in muscle fibers
- DOC for malignancy hyperthermia: interferes with calcium release from sarcoplasmic reticulum
- ADRs: dose dependent muscle weakness and increased LFTs
10
Q
Diazepam
4 important things
2 ADRs
A
- Gold standard
- GABAa receptor
- IV, PO
- Schedule IV
- ADRs: very sedating, ataxia
11
Q
Metaxalone
2 important things
7 ADRs
A
- Sedative properties (not skeletal muscle relaxation)
- Not for long term
- ADRs: very sedating, nausea, headache, dry mouth, urinary retention, nervousness and exacerbates seizures
12
Q
Methocarbamol
3 important things
8 ADRs
A
- Doesn’t directly relax skeletal muscle
- Adjunctive for tetanus
- IV and enteral
- ADRs: drowsiness, dizziness, nystagmus, congestion, facial flushing, bradycardia, nausea, vomiting
13
Q
Orphenadrine
3 important things
1 ADR
A
- Related to diphenhydramine (antihistamine)
- Doesn’t directly relax skeletal muscle
- Anticholinergic, antihistaminic, local anesthetic, slight CNS stimulation
- ADRs: propoxyphene interaction (additive CNS, confusion, anxiety, tremor)
14
Q
Tizanidine
3 important things
7 ADRs
A
- a-Agonist
- Similar efficacy and better tolerated than baclofen or diazepam
- Interacts with cipro
- ADRs: insomnia, weakness, dry mouth, drowsiness, dizziness, hallucinations, increased LFTs
15
Q
A sudden, violent, involuntary contraction of a muscle, attended by pain and interference with function, producing involuntary movement and distortion.
A
Spasm
