Treatment of Muscle Spasms - Chapter 14 Flashcards
Central Vs. Peripheral acting Muscle Relaxants
- Central Acting: Those used to produce muscle paralysis during surgical procedures and in the ICU
- Peripheral Acting: Those used to reduce muscle spasticity in a variety of painful conditions
Symptoms of Spasticity
Positive:
- Increased muscle tone
- Exaggerated tendon jerks
- Hyperexcitable stretch reflex
Negative:
- Muscle weakness
- Decreased endurance
- Reduction in the capacity to make voluntary muscle movements
Conditions That Produce Spasticity
- Spinal chord injury
- Stroke
- Cerebral palsy
- Amyotrophic lateral sclerosis
- Multiple sclerosis
- Muscle strain
Neurotransmitters Involved in Spasticity
- Acetylcholine
- Y-Aminobutyric Acid
- Glycine
- Glutamate
-Spasticity is a symptom of upper motor neuron syndrome. The cause may be excess activity of neurotransmitters (glutamate or ACh), or decreased activity of inhibitory transmitters (Y-aminobutyric acid, glycine)
Drugs Used to Treat Spasticity
- Peripheral acting drugs
- Central acting drugs
Peripheral Acting Drugs Examples
- botulinum toxins
- dantrolene
Brand: Botox
Generic: onabotulinum toxin A
-Inhibits presynaptic release of ACh to cause paralysis in muscles that received injections
Brand: Dantrium
Generic: dantrolene
-Used to treat spasticity associated with spinal chord injury, stroke, cerebral palsy, MS, and malignant hyperthermia
Central Acting Drugs
- Bind to receptor sites that control motor movement in brain and spinal chord
- Categorized according to the mechanism of action
Categories of Central Acting Drugs
- GABAergic
- a2 adrenergic drugs
GABAergic Drugs MOA
-Bind directly to GABA receptors or enhance GABA binding
GABAergic Drugs Examples
- baclofen
- diazepam
Brand: Lioresal
Generic: baclofen
Brand: Valium
Generic: diazepam
A2-Adrenergic Drugs MOA
-Prevent release of excitatory neurotransmitters in spinal cord and increases actions of inhibitory neurotransmitter glycine
