muscle spasm + spasticity

Question 1

What are common causes of muscle spasm?

Answer 1

Epilepsy, hypocalcemia, chronic pain syndromes, trauma, localized skeletal muscle injury.

Question 2

What are non-pharmacologic treatments for muscle spasms?

Answer 2

Immobilization, cold compresses, whirlpool baths, physical therapy.

Question 3

What class of drugs is commonly used to treat muscle spasms?

Answer 3

Centrally acting muscle relaxants.

Question 4

What is the general mechanism of centrally acting muscle relaxants?

Answer 4

Unknown; thought to act on CNS to reduce muscle tone and spasm.

Question 5

What are the uses of centrally acting muscle relaxants?

Answer 5

Relief of localized muscle spasm, pain reduction, increased range of motion, sedation.

Question 6

What are common adverse effects of centrally acting muscle relaxants?

Answer 6

CNS depression, hepatic toxicity, physical dependence, anticholinergic effects.

Question 7

Name examples of centrally acting muscle relaxants.

Answer 7

Diazepam, Tizanidine, Baclofen, Cyclobenzaprine, Methocarbamol, Carisoprodol, Chlorzoxazone, Metaxalone, Orphenadrine.

Question 8

What are conditions that cause spasticity?

Answer 8

Multiple sclerosis (MS), cerebral palsy (CP), spinal cord injury (SCI), stroke.

Question 9

What drugs are used for spasticity?

Answer 9

Baclofen, Diazepam, Dantrolene.

Question 10

What is Baclofen used for?

Answer 10

Spasticity due to MS, SCI, CP (not stroke); preserves muscle strength.

Question 11

What are side effects of Baclofen?

Answer 11

CNS depression, GI upset, urinary retention.

Question 12

What happens with abrupt withdrawal of Baclofen?

Answer 12

PO: hallucinations, paranoia, seizures; Intrathecal: high fever, altered mental status, rebound rigidity/spasticity, rhabdomyolysis, organ failure, death.

Question 13

What is the mechanism of action of Dantrolene?

Answer 13

Acts directly on skeletal muscle to reduce contraction.

Question 14

What is Dantrolene used for?

Answer 14

Spasticity from MS, CP, SCI; also malignant hyperthermia.

Question 15

What are the AEs of Dantrolene?

Answer 15

Hepatic toxicity, muscle weakness, drowsiness, diarrhea, acne-like rash, anorexia, N/V.