In this thread, I would like to discuss about stroke and Tizanidine, a pharmacological agent is to manage spasticity.
Stroke transitioned from being the third to the fourth leading cause of death in the United States (Goodman & Fuller, 2015). Although the decline in mortality, it remains as the leading cause of long term disability (CDC, n.d.). Stroke is a focal vascular-induced injury of the brain. Disruption of blood supply may be caused either by an obstruction (called an ischemic stroke) or by a rupture of blood vessel (called a hemorrhagic stroke) resulting to reduced blood flow to the brain, and eventually neuronal cell death (Goodman & Fuller, 2015).
Stroke is associated with numerous risk factors. These risk factors …show more content…
A sudden weakness of the arm or leg, face drooping, trouble speaking or understanding speech, and trouble seeing, are early signs of stroke (Goodman & Fuller, 2015). Moreover, the effects of a stroke depend primarily on the location of the obstruction and the extent of brain tissue affected (Hossmann & Heiss, n.d.). Spasticity is a post stroke motor disorder which characterized by a velocity dependent increase in tonic stretch reflexes after a lesion in the descending corticospinal system (Thibaut et al., 2013). This is a common is a symptom affecting 30% of stroke patients which could result to functional impairments (Thibaut et al., 2013; Francisco & McGuire, …show more content…
Tizanidine is a central acting alpha-2-adrenergic receptor agonist which selectively binds and stimulate alpha-2 receptors which subsequently reduces spasticity by inhibiting the firing of interneurons, decreasing the release of excitatory neurotransmitters from their presynaptic terminals and reduces the excitability of the postsynaptic neuron (Ciccone, 2016). Tizanidine is widely used to manage spasticity secondary to conditions such as multiple sclerosis (MS), stroke, and spinal cord injury (SCI). According to Rekand (2010), tizanidine is more effective than oral baclofen on cerebrovascular injury related spasticity, yet its use is limited due to somnolence, dry mouth, dizziness, prolonged QT interval and hallucinations, if it exceeds the recommended dose (Ciccone, 2016; Rekand, 2010). Furthermore, tizanidine has been shown to enhance the hypotensive effect of cardiac medications, increase the effect of sedatives -hypnotics, as well as neuropsychiatric adverse reactions of dopaminergic drug (Bakheit, 2012). Nonetheless, compared to oral baclofen and diazepam, tizanidine has a milder side effects and is effective in controlling spasticity without adversely affecting muscle strength (Ciccone,