The Neurological System (Part 1, Halfway Done) Muscle Spasms Flashcards
How many types of meds treat muscle spasms?
2
What are the 2 types of meds that treat muscle spasms?
Centrally Acting Muscle Relaxants
Peripherally Acting Muscle Relaxants
Centrally Acting Muscle Relaxants are used to treat painful muscle spasms that are related to-
Spinal Cord Injury
Multiple Sclerosis
Cerebral Palsy
Musculoskeletal Injury
Other Acute Musculoskeletal Disorders
What is the prototype medication for Centrally Acting Muscle Relaxants?
Baclofen
What’s the therapeutic use of Baclofen?
Relieves skeletal muscle spasm in Spinal Cord Injury + Multiple Sclerosis + Cerebral Palsy
Aside from Baclofen, what are some other Centrally Acting Muscle Relaxants?
Carisoprodol
Cyclobenzaprine
Chlorzoxazone
What is the expected pharmacological action for Centrally Acting Muscle Relaxants?
They enhance the inhibitory effects of GABA on receptors in the spinal cord, resulting in the suppression of hyperactive reflexes
What are some frequent adverse drug reactions to look out for Centrally Acting Muscle Relaxants?
Weakness + Fatigue + Drowsiness + Dizziness
What are some infrequent adverse drug reactions to look out for Centrally Acting Muscle Relaxants?
N/V + Constipation + Urinary Retention
Do Centrally Acting Muscle Relaxants cause physical dependence?
No
Do Centrally Acting Muscle Relaxants cause withdrawal if discontinued abruptly?
After long-term therapy, discontinuing the drug abruptly can cause withdrawal effects
What are the withdrawal effects of Centrally Acting Muscle Relaxants?
Anxiety + Restlessness + Visual Hallucinations + Seizures
How long do you have to take Centrally Acting Muscle Relaxants before you have to taper the dose of the med instead of discontinuing them abruptly?
Several Weeks or Months of therapy
How long would you have to taper off a Centrally Acting Muscle Relaxant?
1 to 2 Weeks
What should be done to minimize the risk of adverse effects to Centrally Acting Muscle Relaxants?
Start off with the lowest effective dose and slowly increase it over time
Ensure that when taking the med PO, it’s taken with food or milk
Encourage the intake of plenty of fluids + dietary fiber
Why would you want to take Centrally Acting Muscle Relaxants with food or milk?
To Decrease Gastric Irritation
Why would you want to encourage a pt to drink plenty of fluids and increase intake of dietary fiber if they are taking any Centrally Acting Muscle Relaxants?
Because constipation is a potential side effect
Do the adverse effects to Centrally Acting Muscle Relaxants usually subside over time?
Yes
If a pt feels dizzy, be sure to tell the pt to-
Change positions slowly
In terms of constipation, what should a pt be taught to do?
If mild laxatives don’t fix constipation, report it to the provider
If drowsiness is a potential adverse effect to drug, always be sure to inform the pt to-
Not drive or perform activities if drowsy
For the PO administration of Baclofen, how much is the dose raised by whenever you want to increase the dosage? What frequency should it be raised?
Raised the dosage by 5 mg every 3 Days
When should you not be raising a pt’s dosage of Baclofen anymore?
When receiving a dose of 20 mg three to four times a day
How should Baclofen be administered if oral administration is ineffective?
Administer by Intrathecal Infusion directly into the spine via a needle attached to a pump
What are the contraindications for Centrally Acting Muscle Relaxants?
Pts may have hypersensitivity to the drug
Don’t take with MAOI’s
Pts shouldn’t be taking Cyclobenzaprine if they have been administered MAOI’s within the past-
2 Weeks
Pts taking Centrally Acting Muscle Relaxants with MAOI’s are at risk for-
Hypotension + Increased CNS Depression
What groups of people should take Centrally Acting Muscle Relaxants with caution?
Older Adults + People with Severe Mental Illness + Children + People with a Seizure Disorder + People who’ve had a Cerebrovascular Accident
Use of Cyclobenzaprine with MAOI’s can cause-
Hyperpyretic Crisis + Seizures
What is a Hyperpyretic Crisis?
Hyperpyrexia is a fever 106.7 F or higher (Life threatening, requires immediate action)
If a pt takes Cyclobenzaprine and is taking an SSRI, SNRI, or Tricyclic Antidepressant at the same time, what can occur?
Serotonin Syndrome
