Isoquinoline derivative:
- pancuronium (Pavulon)
- pipecuronium (Arduan)
- atracurium (Tracrium)
- gallamine (Flaxedil)
- vecuronium (Norcuron)
Spasticity characteristics:
- muscle weakness
- increased flexor muscle spasm
- increase in tonic stretch reflexes
- B & C
- A, B & C
Clinical condition associated with spasticity:
- hypertension
- stroke
- multiple sclerosis
- B & C
- A, B & C
Clinical spasticity mechanisms
- reflex arc involvement
- higher center involvement
- both
- neither
Reduction in spasticity due to drug action:
- alteration in stretch reflex arc
- reduced excitation-contraction coupling at the muscle
- both
- neither
Example(s) of anti-spasmolytic drugs:
- baclofen (Lioresal)
- metaxalone (Skelaxin)
- tizanidine (Zanaflex)
- orphenadrine (Norflex)
- all the above
Baclofen (Lioresal) pharmacology:
- more sedating then diazepam (Valium)
- parenteral administration required
- adverse effect: increased seizure activity in patients with epilepsy
- B & C
- A & C
Concerning intrathecal baclofen (Lioresal):
- Generally favored Route of Administration
- peripheral symptoms common
- major disadvantage is the maintenance of integrity of delivery catheter
- tolerance does not develop
- Significant improvement of the quality of life is not seen
Tizanidine (Zanaflex) pharmacology:
- advantages for patients with spasticity (several types)
- facilitates nociceptor transmission in dorsal horn
- significantly more efficacious compared to diazepam (Valium)
- adverse effects: hypertension
Spasmolytic:: acts by interfering with muscle fiber excitation-coupling mechanism.
- baclofen (Lioresal)
- dantrolene (Dantrium)
- tizanidine (Zanaflex)
Clinical uses: dantrolene (Dantrium)
- spasmolytic
- malignant hyperthermia
- both
- neither
Drugs for acute, local spasm:
- carisoprodol (Soma, Rela)
- chlorphenesin (Maolate)
- methocarbamol (Robaxin)
- orphenadrine (Norflex)
- all the above