The Neurological System (Part 1, Halfway Done) Muscle Spasms

Question 1

How many types of meds treat muscle spasms?

Answer 1

2

Question 2

What are the 2 types of meds that treat muscle spasms?

Answer 2

Centrally Acting Muscle Relaxants

Peripherally Acting Muscle Relaxants

Question 3

Centrally Acting Muscle Relaxants are used to treat painful muscle spasms that are related to-

Answer 3

Spinal Cord Injury
Multiple Sclerosis
Cerebral Palsy
Musculoskeletal Injury

Other Acute Musculoskeletal Disorders

Question 4

What is the prototype medication for Centrally Acting Muscle Relaxants?

Answer 4

Baclofen

Question 5

What’s the therapeutic use of Baclofen?

Answer 5

Relieves skeletal muscle spasm in Spinal Cord Injury + Multiple Sclerosis + Cerebral Palsy

Question 6

Aside from Baclofen, what are some other Centrally Acting Muscle Relaxants?

Answer 6

Carisoprodol
Cyclobenzaprine
Chlorzoxazone

Question 7

What is the expected pharmacological action for Centrally Acting Muscle Relaxants?

Answer 7

They enhance the inhibitory effects of GABA on receptors in the spinal cord, resulting in the suppression of hyperactive reflexes

Question 8

What are some frequent adverse drug reactions to look out for Centrally Acting Muscle Relaxants?

Answer 8

Weakness + Fatigue + Drowsiness + Dizziness

Question 9

What are some infrequent adverse drug reactions to look out for Centrally Acting Muscle Relaxants?

Answer 9

N/V + Constipation + Urinary Retention

Question 10

Do Centrally Acting Muscle Relaxants cause physical dependence?

Answer 10

No

Question 11

Do Centrally Acting Muscle Relaxants cause withdrawal if discontinued abruptly?

Answer 11

After long-term therapy, discontinuing the drug abruptly can cause withdrawal effects

Question 12

What are the withdrawal effects of Centrally Acting Muscle Relaxants?

Answer 12

Anxiety + Restlessness + Visual Hallucinations + Seizures

Question 13

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?

Answer 13

Several Weeks or Months of therapy

Question 14

How long would you have to taper off a Centrally Acting Muscle Relaxant?

Answer 14

1 to 2 Weeks

Question 15

What should be done to minimize the risk of adverse effects to Centrally Acting Muscle Relaxants?

Answer 15

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

Question 16

Why would you want to take Centrally Acting Muscle Relaxants with food or milk?

Answer 16

To Decrease Gastric Irritation

Question 17

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?

Answer 17

Because constipation is a potential side effect

Question 18

Do the adverse effects to Centrally Acting Muscle Relaxants usually subside over time?

Answer 18

Yes

Question 19

If a pt feels dizzy, be sure to tell the pt to-

Answer 19

Change positions slowly

Question 20

In terms of constipation, what should a pt be taught to do?

Answer 20

If mild laxatives don’t fix constipation, report it to the provider

Question 21

If drowsiness is a potential adverse effect to drug, always be sure to inform the pt to-

Answer 21

Not drive or perform activities if drowsy

Question 22

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?

Answer 22

Raised the dosage by 5 mg every 3 Days

Question 23

When should you not be raising a pt’s dosage of Baclofen anymore?

Answer 23

When receiving a dose of 20 mg three to four times a day

Question 24

How should Baclofen be administered if oral administration is ineffective?

Answer 24

Administer by Intrathecal Infusion directly into the spine via a needle attached to a pump

Question 25

What are the contraindications for Centrally Acting Muscle Relaxants?

Answer 25

Pts may have hypersensitivity to the drug

Don’t take with MAOI’s

Question 26

Pts shouldn’t be taking Cyclobenzaprine if they have been administered MAOI’s within the past-

Answer 26

2 Weeks

Question 27

Pts taking Centrally Acting Muscle Relaxants with MAOI’s are at risk for-

Answer 27

Hypotension + Increased CNS Depression

Question 28

What groups of people should take Centrally Acting Muscle Relaxants with caution?

Answer 28

Older Adults + People with Severe Mental Illness + Children + People with a Seizure Disorder + People who’ve had a Cerebrovascular Accident

Question 29

Use of Cyclobenzaprine with MAOI’s can cause-

Answer 29

Hyperpyretic Crisis + Seizures

Question 30

What is a Hyperpyretic Crisis?

Answer 30

Hyperpyrexia is a fever 106.7 F or higher (Life threatening, requires immediate action)

Question 31

If a pt takes Cyclobenzaprine and is taking an SSRI, SNRI, or Tricyclic Antidepressant at the same time, what can occur?

Answer 31

Serotonin Syndrome