Nocturnal leg cramps Flashcards
(16 cards)
What is a leg cramp?
A sudden, involuntary, painful muscle contraction, usually in the calf, and sometimes in the foot or thigh.
When do leg cramps most commonly occur?
At night (nocturnal), particularly in older adults.
What are the most common causes of leg cramps?
Most are idiopathic (no identifiable cause).
Name four secondary causes of leg cramps.
Medications (e.g. diuretics)
Metabolic disturbances (e.g. electrolyte imbalances)
Neurological conditions
Pregnancy
What non-pharmacological self-care measures help relieve leg cramps?
Stretching and massaging the muscle, staying active, staying hydrated, and using appropriate footwear.
Is analgesia recommended during a cramp? Why or why not?
No — most cramps are short-lived; analgesia may be used after cramps if there’s residual tenderness.
Is quinine recommended for routine treatment of idiopathic leg cramps?
No — due to poor benefit-to-risk ratio and potential toxicity.
When might quinine be considered for leg cramps?
If cramps are frequent and painful, affecting sleep or quality of life, and non-drug treatments have failed.
What is the initial trial duration for quinine in leg cramp management?
Up to 4 weeks.
How often should quinine therapy be reassessed or interrupted?
Every 3 months, to assess the need for continued use.
What are the risks of quinine overdose?
Quinine is toxic in overdose and can be fatal.
What is the usual adult dose of quinine sulfate for leg cramps?
300 mg at night.
Why is quinine not routinely recommended for idiopathic leg cramps?
Because the benefit-to-risk ratio is poor due to potential toxicity, including serious side effects like thrombocytopenia, arrhythmias, and hypersensitivity reactions.
What serious blood disorder can quinine cause, requiring patient monitoring?
Thrombocytopenia — patients should be advised to report unexplained bruising or bleeding.
What should a patient be warned about when starting quinine?
Risk of side effects such as tinnitus, blurred vision, nausea, thrombocytopenia, and overdose toxicity.
What is the advice regarding the safety of quinine in overdose?
Quinine is toxic in overdose — can lead to fatal arrhythmias, convulsions, or blindness; it must be used cautiously and stored out of reach.
