Transcript Lorem Ipsum - NAU jan.ucc.nau.edu web server

Central Acting Muscle Relaxants
& Spasmolytics
Central Acting Muscle
Relaxants
Drugs That Are Used In
Institutional Settings Are :
 Baclofen (Lioresal)
 Diazepam (Valium)
Central Acting Muscle
Relaxants




Methocarbamol (Robaxin)
Cyclobenzaprine HCl (Flexeril)
Chlorzoxazone (Paraflex)
Carisoprodol (Soma)



Chlorphenesin Carbamate (Maolate)
Orphenadrine Citrate (Norgesic)
Metaxalone (Skelaxin)
Central Acting Muscle Relaxants
& Spasmolytics


Baclofen (Lioresal)
Diazepam (Valium)

Used To Relieve :
 Muscle Spasm
 Spasticity
Central Acting Muscle Relaxants


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Methocarbamol (Robaxin)
Cyclobenzaprine HCl (Flexeril)
Chlorzoxazone (Paraflex)
Carisoprodol (Soma)



Chlorphenesin Carbamate (Maolate)
Orphenadrine Citrate (Norgesic)
Metaxalone (Skelaxin)
Only Used To Relieve:
Muscle Spasm
Baclofen

A Derivative Of GammaAminobutyric Acid (GABA)

Acts As A GABA Agonist
 Binds To GABA Receptors
 Acts As An Inhibitory
Neurotransmitter
 Has Identical Actions To
GABA

Baclofen Exerts Its Antispastic
Effects In The Spinal Cord
 Suppresses Monosynaptic &
Polysynaptic Transmission

Hyperpolarizes Neural Cells
 Inhibits Calcium Channel
Activity
 Increasing Potassium
Conductance Into Cells


Reduces The Frequency Of
Flexor And Extensor Spastic
Events
Reduces The Severity Of The
Spastic Episode
Baclofen - Medical Uses


Used To Treat Spasticity In SCI
Patients
Used To Treat Spasticity In MS
Patients
Baclofen - Side Effects



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Drowsiness
Insomnia
Dizziness
Weakness



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Hypotension
Ataxia
Mental Confusion
Inability To Focus On Tasks
Diazepam

Diazepam Is A Benzodiazepine
 Has Sedative Qualities
 Has Anxiolytic Capabilities
 Is A Spasmolytic Drug
Mechanism Of Action
Potentiates Action of GABA
 Increases The Presynaptic And
Postsynaptic Inhibition At All
Levels In The CNS

Diazepam - Medical Uses
A Sedative
 As A Hypnotic
 As An Anxiolytic
 As A Muscle Relaxant

Diazepam - Medical Uses
Relieve The Spasticity of
Cerebral Palsy
 Induce Mild Amnesia
 Control Seizures In Status
Epilepticus Patients

Diazepam - Adverse Side Effects
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Cardiorespiratory Depression
Drowsiness
Fatigue
Lethargy
Somnolence (Drowsy, Sleepy)




Hypotonia
Dysarthria
Ataxia
Behavioral Disturbances

Lifting of Inhibitions

Children
 Irritability & Aggression
 Hyperactivity
 Anorexia
 Increased Production of Saliva
& Bronchial Secretions
Central Acting Muscle Relaxants







Methocarbamol (Robaxin)
Cyclobenzaprine HCl (Flexeril)
Chlorzoxazone (Paraflex)
Carisoprodol (Soma)
Chlorphenesin Carbamate (Maolate)
Orphenadrine Citrate (Norgesic)
Metaxalone (Skelaxin)
Mechanism Of Action

Lack Of Controlled Clinical Trials
Makes Assessing The Efficacy Of
These Medications Difficult
 However, They May Relieve:
 Muscle Spasm
 Decrease Pain By Relieving
Spasm

Not Been Conclusively Determined

Research Suggests :
 Nonspecific CNS Sedation
 Suppression Of Polysynaptic Spinal
Cord Transmission
Decreased Alpha Motor Neuron
Traffic With A Decrease In Spasm
 May Act As An Antidepressant Mood Alterations

Medical Uses

Used As An Adjunct To Rest And
Physical Therapy In Patients With
Acute Musculoskeletal Pain And
Spasm
Peripheral Acting Muscle
Relaxants
Peripheral Muscle Relaxants


Dantrolene Sodium (Dantrium)
Quinine Sulfate (Quinamm)
Dantrolene Sodium (Dantrium)
Dantrolene : Peripheral Muscle
Relaxants


Act Directly On The Skeletal
Muscle To Produce Relaxation
Do Not Have Actions Directly On
The Spinal Cord
Dantrolene Sodium
Mechanism Of Action

Decreases The Amount Of
Calcium Released From The
Muscle's Sarcoplasmic
Reticulum
Reduces The Contractility Of
Muscle
 Has A Greater Effect On Type
II Skeletal Muscle Fibers (Fast
Twitch)

Side Effects - Dantrolene Sodium




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Fatigue
Euphoria
Drowsiness
It Can Be Hepatotoxic
Liver Enzymes May Be Elevated
Muscle Weakness - Dose Related
Dantrolene - Therapeutic Uses

Helps Manage Spasticity
 Cerebral Palsy
 Multiple Sclerosis
 Spinal Cord Injury

Helps Manage Spasticity
 Reduces Clonus
 Reduces Mass Reflex Movements
 Abnormal Resistance To Passive
Stretch
 Used In Bed Bound Patients To
Improve Their Bed Care
Dantrolene - Unusual
Therapeutic Uses

Malignant Hyperthermia
Hereditary Condition
Multiple Triggering Mechanisms
 Anesthesia
 Drugs
 Illness & Stress
 Triggering Mechanism Results In
Prolonged Calcium Release


Malignant Hyperthermia
 Massive Muscle Contraction
 Excessive Lactate Production
 Pronounced Increase In Core
Temperature
Quinine Sulfate (Quinamm)
Quinine Sulfate
 Quinine
Sulfate Is Related To
The Cinchona Alkaloids - An
Antimalarial Drug Group

Quinine Sulfate :
 It Is An Antipyretic Drug
 It Is A Local Anesthetic
 It Is An Analgesic
 It Is A Muscle Relaxant

Quinine Sulfate Acts To:
 Decreases The Excitability Of The
Motor End-Plate
 Makes The Muscle Less
Susceptible To Repetitive Neural
Stimuli
 Less Responsive To Acetylcholine
Adverse Side Effects
For Quinine Sulfate

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Rashes
Syncope
Headaches
Hot, Flushed Skin
Ringing In The Ears

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Fever
Vomiting
Delirium
Confusion
Nausea
Quinine Sulfate : Medical Uses

Prescribed For Myotonia Congenita
 An Inherited Disease Seen In
Children
 Tonic Spasms That Occur When
Voluntary Movement Occurs
 Rigidity Wears Off & Movement
Becomes More Fluid With
Repeated Contractions
 Quinine
Sulfate Obliterates The
Spasticity Of Myotonia Congenita
Clinical Considerations
 Patients
with glaucoma should not
use these medications
 Patients with a history of urinary
retention should not use these
medications
 Patients
should not be doing
hazardous activities while on these
medications
 A diabetic’s blood glucose should be
monitored closely while on these
medications - hypo & hyperglycemia
 Watch
the patient for :
 Loss
of coordination
 Ataxia
 Possible seizure activity