Muscle relaxants chapter 25

Question 1

What is muscle spasm?

Answer 1

Often results from injury to the musculoskeletal system
* Caused by the flood of sensory impulses coming to the spinal cord
from the injured area

Question 2

What is muscle spasticity?

Answer 2

• Result of damage to neurons within the CNS not peripheral
  structures
• May result from an increase in excitatory influences or a decrease
  in inhibitory influences within the CNS
• Caused by nerve damage, is permanent.

Question 3

What is baclofen (Lioresal)?

Answer 3

Centrally acting skeletal muscle relaxants

Question 4

What are therapeutic actions of baclofen (Lioresal)?

Answer 4

Centrally acting skeletal muscle relaxants

Interfere with reflexes in CNS causing the spasm, not peripheral
structures
* Causes CNS depression

Question 5

What are indications of baclofen (Lioresal)?

Answer 5

Centrally acting skeletal muscle relaxants
* Alleviation of signs and symptoms of spasticity
* Used in spinal cord injuries or neuromuscular diseases in conjunction with rest, PT, etc

Question 6

What are adverse effects of of baclofen (Lioresal)?

Answer 6

Centrally acting skeletal muscle relaxants

r/t CNS depression —> sleepiness, weakness, confusion, HA
Hypotension, GI (n/v; constipation)

Question 7

What are contras of baclofen (Lioresal)?

Answer 7

Centrally acting skeletal muscle relaxants

-Spasms caused by rheumatic dz(No beneficial)

-Spasticity that is necessary for locomotion, increased function( like someone who needs wot walk, sit, grab things)

Question 8

What are cautions of baclofen (Lioresal)?

Answer 8

Centrally acting skeletal muscle relaxants

h/o seizure disorder
(because the CNS depression and imbalance caused by these drugs may exacerbate the seizure disorder;)

Question 9

What are drug interactions with baclofen (Lioresal)?

Answer 9

Centrally acting skeletal muscle relaxants

potentiation with other CNS meds/ ETOH(CNS depression can increase)

Wean to discontinue

-They should wean 1-2 off medication because if you stop immediately it can cause psychosis or hallucinations. Stop medication slowly

Question 10

What is dantrolene (Dantrium)?

Answer 10

Direct acting skeletal muscle relaxants

Question 11

What are therapeutic actions of dantrolene (Dantrium)?

Answer 11

Direct acting skeletal muscle relaxants

-Inhibits release of calcium from muscle fibers which prevents muscle contraction
-Affects peripheral muscle contraction by entering muscle and preventing contraction

Question 12

What are indications of dantrolene (Dantrium)?

Answer 12

Direct acting skeletal muscle relaxants

-Treatment of spasticity associated with neuromuscular disease
-Malignant hyperthermia

Question 13

What are pharmacokinetics of dantrolene (Dantrium)?

Answer 13

Direct acting skeletal muscle relaxants

Crosses placenta and enters breastmilk

Question 14

What are adverse effects of dantrolene (Dantrium)?

Answer 14

Direct acting skeletal muscle relaxants

-r/t CNS depression  drowsiness, fatigue, weakness, confusion, HA
-GI effects  diarrhea, constipation, abd cramps
Hepatitis

Question 15

What are contras of dantrolene (Dantrium)?

Answer 15

Direct acting skeletal muscle relaxants

-Spasms caused by rheumatic dz
-Spasticity that is necessary for locomotion, increased function
-Active hepatic dz. Due to adverse affect of hepatitis

Question 16

What are cautions of dantrolene (Dantrium)?

Answer 16

Direct acting skeletal muscle relaxants

hx of hepatic dz, respiratory dz, cardiac dz’

history of liver disease or previous dysfunction, which could make the liver more susceptible to cellular toxicity; in patients with respiratory depression, which could be exacerbated by muscular weakness; in patients with cardiac disease because cardiac muscle depression may be a risk;

Question 17

What are drug interactions with dantrolene (Dantrium)?

Answer 17

Direct acting skeletal muscle relaxants

when combined with estrogen, hepatic risk increases