Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
22 Cards in this Set
- Front
- Back
|
What indication is there for using skeletal muscle relaxants?
|
treat conditions associated with hyperexcitable skeletal muscle
|
|
|
What is the goal in using skeletal muscle relaxants?
|
to normalize excitability without decreasing muscle function
|
|
|
What is the difference between muscle spasm and spasticity?
|
SPASM: increase in muscle tension, peripheral nerve injury, MS/inflammation, continuous contraction, involuntary contraction
SPASTICITY: increase in muscle excitability, CNS (LMN), velocity dependent, change in motor control and in reflex arcs |
|
|
Name 2 drugs used to treat muscle spasms (antispasmotic).
How are these drugs usually administered? |
1. Flexeril/cyclobenzaprine (polysynaptic inhibitors)
2. Diazepam/Valium Administered orally |
|
|
Why is Diazepam/Valium not usually used for treating muscle spasms?
|
the doeses needed to relax skeletal muscle have side effects (sedation)
|
|
|
Name 3 side effects that are common to the antispasmotic drugs.
|
1. sedation (due to decrease in CNS activity)
2. physical dependence 3. tolerance |
|
|
TRUE or FALSE: Antispasmotic drugs are often used on a long term basis.
|
FALSE -- indicated for short term use only, combined with PT interventions
|
|
|
Name the 6 different drugs that are used to treat spasticity.
|
1. Baclofen/Lioresal
2. Diazepam/Valium 3. Neurontin/Gabapentate 4. Dantrolene sodium/Dantrium 5. Tizanidine/Zanaflex 6. Botulinum A (and B) |
|
|
How is Baclofen/Lioresal administered?
|
oral or interthecal
|
|
|
What is Baclofen/Lioresal's mechanism of action?
|
it is a GABA antagonist (GABA is an inhibitory NT), the meds bind to the synapse for alpha motor neuron so the GABA can't bind which decreases spasticity
|
|
|
How does Diazepam/Valium work to decrease spasticity?
|
it inhibits the CNS, but by doing so causes marked sedation
- long term use is avoided |
|
|
Describe the mechanism for Neurontin/Gabapentate.
Side effects? |
inhibits the spinal cord similarly to GABA, used with other drugs
Side Effects: fatigue, ataxia, and sedation |
|
|
How does Dantrolene sodium/Dantrium decrease spasticity?
Side effects? |
- drug acts at muscle and NOT at CNS
- blocks Ca++ from being released into sarcoplasm reticulum - Ca++ release is needed for muscle to be able to contract - by inhibiting Ca++ release, stops muscle contractions (however it is non-specific) Side effects: generalized muscle weakness, liver toxicity (not likely, but severe if it occurs) |
|
|
1. What is Tizanidine/Zanaflex's mechanism of action?
2. Indications for use? 3. Side effects? |
1. alpha-2 adrenergic agonist
2. use after spinal lesion, possibly after cerebral lesion (but not acute) 3. generalized muscle weakness, sedation, dizzy, dry mouth |
|
|
What are 3 indications for using Botox A?
|
1. control localized muscle dystonias
2. reduce spasticity in specific muscle groups 3. control muscle hyperexcitability |
|
|
How is Botox A administered?
Adverse effects? |
administered through injection into specific muscles
if used systemically can cause widespread paralysis (DIAPHRAGM!!!!) |
|
|
What is Botox A's mechanism of action?
|
it cleaves fusion proteins, inhibiting ACh from being released into the NMJ or into muscle cells
|
|
|
When might Botox B be used?
|
in the case of an immune response to Botox A
|
|
|
What are some cons of Botox A useage?
|
-does not cure spasticity
- can only treat a limited number of muscle groups at one time (too high of a dose can cause immune response) |
|
|
TRUE or FALSE: Most skeletal muscle relaxants are not absorbed well from the GI tract.
|
FALSE. Most ARE absorbed well from GI tract
|
|
|
Drug metabolism is usually via ________ enzymes.
|
LIVER
|
|
|
Where does excretion of the drugs occur?
|
intact drug or metabolite are excreted through the KIDNEYS
|
