Muscle Relaxants

Question 1

More than 12 million people worldwide have ____________ ____________

Answer 1

muscle spasms

Question 2

Dystonia affects over ____________ people in the U.S. The 3rd most common movement disorder, following essential tremor and Parkinson’s .

Answer 2

250,000

Question 3

____________ is a chronic neurologic disorder, is characterized by involuntary muscle contraction that forces body parts into abnormal, occasionally painful movements or postures.

Answer 3

Dystonia

Question 4

Purpose of muscle relaxants: used to relieve muscular spasms and pain associated with traumatic injury and spasticity from chronic debilitating disorders such as ____ , ____________ ____________, ____________ ____________ ____________.

Answer 4

MS
cerebral palsy
spinal cord injuries.

Question 5

____________ results from increased muscle tone from hyperexcitable neurons caused by increased stimulation from the cerebral neurons or lack of inhibition in the spinal cord or at the skeletal muscles.

Answer 5

Spasticity

Question 6

Pharmacological and Non pharmacologic treatment of muscle spasms:
• _____-____________: Immobilization, application of heat and /or cold, hydrotherapy, therapeutic ultrasound, supervised exercises, massage and manipulation
• ____________: analgesics, anti-inflammatory agents, central acting muscle relaxants

Answer 6

• Non-pharmacologic:

* Pharmacologic:

Question 7

____________________________________: exact mechanism is unknown. Believed work by CNS depressant effect or altering simple spinal reflexes. Common medications in this class follow:

Answer 7

Central Nervous System Muscle Relaxants

Question 8

• ____________ (Lioresal): structurally similar to. Used to reduce muscle spasms in pts with MS, CP, spinal cord injury. Common S.E.: drowsiness, dizziness, weakness, fatigue. Popular as it has a wide safety margin.

Answer 8

• baclofen

Question 9

• ________________(Flexeril): depresses motor activity primarily at the brainstem, limited effect on the spinal cord. Used for short term therapy of 2 to 3 weeks. Used for acute muscle spasticity. Side effects: drowsiness, blurred vision, dizziness, dry mouth, rash and tachycardia. Rare: swelling of the tongue

Answer 9

• Cyclobezaprine

Question 10

• ____________ (Zanaflex): inhibits motor neurons mainly at the spinal cord level. Centrally acting alpha2 adrenergic agonists. High doses report drowsiness. Common side effects: dry mouth, fatigue, dizziness, and sleepiness.

Answer 10

• tizanidine

Question 11

• ____________ (Sabril): used for infantile spasms and complex partial seizures

Answer 11

• Vigabatrin

Question 12

• _________________: diazepam (Valium), clonazepam (Klonopine): dizziness, sedation, ataxia, light headedness, respiratory depression

Answer 12

• Benzodiazepines

Question 13

____________________________________:
• _______________(Dantrium) produces an antispasmodic effect at the level of the neuromuscular junction and skeletal muscle. It does this by interfering (blocks) the release of calcium ions in skeletal muscle. Especially useful for muscle spasms when they occur after spinal cord injury, stroke, Cerebral Palsy, MS. Also used for treatment of malignant hyperthermia. Common side effects: muscle weakness, dizziness, diarrhea, dry mouth, tachycardia, erratic BP, urinary retention. Serious side effect: hepatic necrosis

Answer 13

Direct –acting antispasmodics:

• Dantrolene