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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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