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Pharm Test 2
Pharm Test 2 Ch. 13 Skeletal Muscle Relaxants
| What are skeletal muscle relaxants used for? | treat conditions associated w/ hyper-excitable skeletal muscle - muscle spasms and spasticity |
| What is the important function of a muscle relaxer to a physical therapy? | To allow for the Pt to engage more in activity |
| The goal of skeletal muscle relaxants are to? | decrease muscle excitability by acting on the spinal cord level |
| Do skeletal muscle relaxers decrease pain? | yes |
| Do skeletal muscle relaxers improve motor function? | yes |
| Spasticity occurs from? | a result of a previous disease or injury |
| Where would you see the main cause of spasticity? | injury to the CNS |
| Examples of spasticity at the spine | multiple sclerosis and spinal cord transection |
| Examples of spasticity at the brain | CVA, cerebral palsy, acquired brain injury |
| How would you characterize spasticity? | rapid lengthening of the muscle invoking a strong contraction in the stretched muscle - abnormal reflex activity-> velocity dependent-> a rapid lengthening of muscle |
| What is lost in spasticity? | supraspinal inhibition or control |
| Spasms occur when what happens? | increase in tension often seen in skeletal muscles after certain musculoskeletal injuries and inflammation |
| Examples of injuries that could bring a spasm about? | muscle strain or nerve root impingement |
| Are spasm voluntary or involuntary? | involuntary |
| Are spasm continuous or non continuous? | continuous |
| What is built up when there is a tonic contraction of affected muscle from a spasm? | lactate |
| is Diazepam a anti-spasm drug or anti spasticity? | anti-spasm |
| what type of drug is Diazepam? | benzo!!!! |
| How does Diazepam work? | increasing the central inhibitory effects of GABA and induced inhibition at the synapse - works on alpha motor neurons -can exert some sedative effects |
| Valium is used when? | to inhibit spasms of the larynx |
| What are adverse effects of Diazepam? | addiction, tolerance, sedation, decrease in psychomotor ability |
| Types of central acting anti-spasm drugs | carisoprodol and cyclobenzaprine |
| How do central acting anti-spasm drugs work? | decrease polysynaptic reflex activity in the spinal cord - decreases alpha motor neuron excitability -DECREASE ALPHA MOTOR ACTIVITY BY INHIBITING GAB, SERORTONIN OR POLYSYNAPTIC PATHWAYS |
| are these drugs used for long term or short term relief? | short term |
| are these drugs often given w/ NSAIDs? | yes |
| What class of drug is Carisoprodol "Soma"? | 4 |
| An example of anti-spasticity drug is... | Baclofen |
| Baclofen is a derivative of what? | the central inhibitory neurotransmitter GABA |
| Does baclofen act on GABA A or B receptors? | B |
| once it acts on the receptor is does what? | enables the drug to act as a GABA agonist - then leads to inhibiting transmission within the spinal cord causing a decreased firing of the alpha motor neuron |
| How is bacloen administered? | orally, can be intrathecal |
| T/F Baclofen is highly effective in treating Pt's with suprspinal lesions? | False |
| T/F Baclofen causes more generalized muscle weakness than direct acting relaxants | False |
| Adverse effects of Baclofen are? | transient drowsiness, hallucination in elderly or CVA |
| Intrathecal Baclofen is administered where? | directly into the subarachnoid space surrounding a specifc level of the spinal cord |
| Does intrathecal Baclofen require large or small doses? | small |
| Can pumps be uses to administer intrathecal baclofen? | yes |
| Dantrolen sodium works by? | exerts its effect directly on the skeletal muscle cell - binds to ryanodine type 1 receptor - inhibits the release of calcium |
| Dantrolene sodium is a antispsticity or spasm drug? | antispasticity |
| T/F Dantrolene sodium is prescribed to treat muscle spasms caused by musculoskeletal injury? | False |
| When is Dantolene sodium used? | in Pts with traumatic spinal cord lesions, advanced MS, cerebral palsy, or CVAs |
| Can Diazepam be used for spasticity as well as spasms? | YES |
| is Gabapentin anti-spasticity or antispasm drug? | antispasticity |
| Gabapentin works by.. | inhibiting calcium entry into presynaptic nerve terminals that relase glutamate |
| When is gabapentin used? | when there is a spinal cord injury |
| T/F Side affects of Gabapentin are sedation, fatigue, dizziness and ataxia | true |
| is Tizanidine used in spasms or spasticity cases? | spasticity cases |
| Tizanidine is classified as what kind of agonist? | alpha 2 adrenergic |
| Alpha 2 adrenergic receptors are found where? | brain and spinal cord |
| T/F stimulating alpha 2 receptors inhibits the firing of internerurons that relay info to the alpha neuron | true |
| How does Tizanidine work? | decreases the release of excitatory NTs from presynaptic terminals and decreases the excitability of the postsynaptic neuron |
| Tizanidine is mostly used with what kind of pathology? | spinal lesion but can be cerebral lesion |
| TIzanidine is administered... | orally |
| T/F Tizanidine is the superior alpha-2 agonist drug | true |
| Adverse effects of Tizanidine are | sedation, dizziness, dry mouth |
| Botox is used to control what? | hyper-excitability in the muscles |
Created by:
hfillingim
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