|
CH 251, Respiratory Drugs, Skeletal Muscle Relaxants,
Antihypertensive Drugs, Angina Pectoris,
Cardiac Arrhythmias,
Congestive Heart Failure,
Coagulation
Disorders and Hyperlipidia, Endocrine Pharmacology,
Male and Female Hormones,
Thyroid and Parathyroid,
Diabetes
Final Exam Objectives
SKELETAL MUSCLE
RELAXANTS
Spasticity: exaggerated muscle stretch reflux
caused by loss of control in spinal cord or brain.
Caused by cerebral accident, traumatic lesions in the brain or multiple
sclerosis.
Spasms: increased tension, usually involuntary
Two kinds of muscle relaxants:
Centrally acting (act on spinal cord) and direct acting (on the muscle)
|
Treatment
|
Used in
|
Mechanism
|
Adverse effects
|
|
Centrally Acting
|
|
|
|
|
Baclofen
|
Spasticity associated with lesions of spinal cord.
Good in MS.
|
Given orally and intrathecally in severe cases.
Releases GABA
|
Drowsiness, confusion, hallucinations. Adverse
effects are individual based.
|
|
Diazepam (Valium)
|
Patients with cord lesions and cerebral palsy
|
|
Sedation, tolerance and dependance.
|
|
Combination
|
Other drug mechanisms are not understood well and are
generally used as adjunct to PT. Most
drugs are combined with analgesics
|
Eg Parafon Forte (clorozoxazone and acetaminophen)
Norgesic (orphenadrine and aspirin)
|
Dizziness, headaches
|
|
Direct Acting
|
|
|
|
|
Dantrolene Sodium (Dantrium)
|
Traumatic cord lesions, advanced MS, cerebral palsy.
(not used for muscle spasms)
|
Inhibits release of calcium within muscle
|
Muscle weakness, severe hepatotoxicity
|
|
Other eg Botulinum toxin (Botox)
|
|
Prevents release of acetylcholine
|
|
Spasms:
can be treated by opioid or non-opioid analgesics.
Most common side effect is sedation.
|