Muscle Relaxants, Kinder Flashcards Preview

Year 2 neuro exam 2 > Muscle Relaxants, Kinder > Flashcards

Flashcards in Muscle Relaxants, Kinder Deck (44):
1

What are the centrally acting spasmolytics

baclofen
tizanidine
diazepam

2

What drugs are used for local muscle spams

carisoprodol
cyclobenzaprine

3

what are the non-centrally acting spasmolytics

dantrolene
botulinum toxin

4

what are the Immunologic drugs used for MS

Interferons: beta1a beta1b
Glatiramer acetate
Mitoxantrone
Glucocorticoids

5

Spasticity

increase in tonic stretch reflexes and flexor muscle spasms with muscl eweakness

6

negative effects of spasticity

pain
decreased mobility
contractures
muscle spasms

7

mech of spasticity

UMN lesions
hyperexcitability of alpha motor neurons in cord

8

ways to modify reflex arc

reduce activity of Ia fibers that excite primary motor neuron
enhance activity of inhibitory internuncial neurons

9

MOA baclofen

agonist GABAb R
results in hyperpolarization from closing presynaptic CaCh, inc K postsynaptic Ch, inhibits dendritic Ca influx
suppress Ia sensory afferents interneurons and motor neurons
may reduce substance P

10

baclofen vs diazepam

baclofen as effective and less sedation side effect

11

adverse effects baclofen

drowsiness
increased seizure activity in epileptic patients(slow withdrawal)
confusion, dizziness, hypotonia, psych disturbances, insomnia, slurred speech, ataxia and muscle weakness

12

use baclofen

spascticiy in MS or spinal cord lesions
intrathecal for intractable spasticity from cord lesion, MS or spinal diseases

13

MOA Tizanidine

a2 agonist that reinforeces presynaptic and postsynaptic inhibition in cord
inhibits nociceptive transmission in dorsal horn

14

adverse effects tizanidine

less muscle wekaness but has drowsiness (take at night)
hypotension, dizziness, dry mouth asthenia and hepatotoxicity!!

15

use tizanidine

muscle spasticity

16

MOA diazepam

benzo that promotes binding to GABAa R and enhances those currents increasing inhibition and reduce spasticity

17

use diazepam

sedation, hypnotic effects, muscle relaxant, anxiolytic, anticonvulsant
anxiety disorders, ethanol withdrawal Sx, convulsive disorders, operation sedation and amnesia

18

adverse effects diazepam

CNS depression and sedation
risk of dependence with use
amnestic effects

19

what drugs are used for relief of acute muscl spasm caused by local tissue trauma or muscle strain

carisoprodol and cyclobenzaprine
work at brainstem

20

MOA carisoprodol

CNS depressant
metabolized to meprobamate which is sedative and anxiolytic

21

use of carisoprodol

short term Tx
2-3 weeks MSK pain

22

adverse effects carisoprodol

drowsiness and dizziness
addictive

23

MOA cyclobenzaprine

reduce tonic somatic motor activity by influencing alpha and gamma motor neurons

24

therapeutic use cyclobenzaprine

muscle spams with acute, painful MSK conditions (no longer than 2-3 weeks)
not useful for spinal cord injury or cerebral palsy

25

adverse effects cyclobenzaprine

like tricyclic antidepressant, has antimuscarinic effects like sedation confusion and transient hallucinations
dizziness and xerostomia

26

What arc does dantrolene interfere with

the excitation-contraction coupling

27

MOA dantrolene

inhibit Ryanodine R Ca channel blocking Ca release form ST and contraction then impaired
Does NOT affect cardiac and smooth muscles

28

therapeutic use dantrolene

spasticity with UMN disorders and management malignant hyperthermia!!!

29

adverse effects dantrolene

muscle weakness, sedation, hepatitis

30

CI dantrolene

hepatitis

31

what can trigger malignant hyperthermia

volatile anesthetics
Neuromuscular blocking drugs like succinylcholine

32

what happens in malignant hyperthermia

after triggered by agent large amounts Ca released causing massive muscle contraction, increased temp and lactic acid production
hence why dantrolene is administered

33

MOA botulinum

zinc endopeptidase cleaves specific proteins in needed for vesicular fusion that allow Ach release. so blocks this release

34

use of botulinum toxin

cervical dystonia, blepharospasm, severe primary axillary hyperhirosis
prophylaxis chronic migraines
Tx incontinence from overactive bladder

35

adverse effects botulinum

focal muscle weakness

36

MOA interferons used in MS

enhance suppressor T cell activity
reduces proinflammatory cytokines
down regulates Ag presentation
reduces trafficking of lymphocytes into CNS

37

effects of interferons in MS

improves MRI lesions, decrease relapse rate and dec severity

38

adverse effects interferons in MS

injection site reactions, flu like Sx, high prevalence of asymptomatic liver dysfunction
leukopenia, anemia and suicide

39

MOA glatiramer acetate

mixture polymers of 4 amino acids
L alanine, L glutamic acid, L Lysine, L tyrosine
similar to myelin basic protein
"decoy"

40

adverse effects to glatiramer acetate

local injection site reactions, transient systemic postinjection reactions(chest pain, flushing, dypsnea, palpitations, anxiety)

41

what type of drug is Mitoxantrone

antineoplastic used for MS, AML and prostate CA

42

MOA mitoxantrone

intercalates into DNA causing breakage

43

bad side effect of mitoxantrone and how is it used

cardiac toxicity
reserved for rapidly advancing disease who failed other Tx

44

Glucocorticoid in MS

monthly IV bolus used to Tx primary or secondary progressive MS alone or in combo with other immunomodulatory or immunosuppressive medications