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MOA CNS sedatives/depressants
Metalaxone (Skelaxin)
Methocarbamol (Robaxin)
Chlorzoxazone (paraflex, parafon forte)
exact MOA unknown
-does not work on skeletal muscle or neuromuscular juntion
-achieve effect by sedation
- do not have analgesic or anti-inflammatory effects
-Does reduce involuntary muscle contractions and muscle spasms from skeletal injury.
DO NOT treat spasticity by CNS disease
Methocarbamol (Robaxin) can cause
CNS depression
Chlorzoxazone (Paraflex, parafon forte) acts at the....
spinal cord and subcortical levels. Inhibits reflex arc.
Carisoprodol (Soma) is metabolized to....
MOA
meprobamate (similar to barbiturates)
but blocks interneuronal activity in descending reticular formation and spinal cord.
TCA relatives - Cyclobenzaprine (flexeril) MOA
acts on CNS to reduce tonic somatic motor activity.
Causes reserpine antagonism, nor epi potentiation, potent anticholinergic effects and sedation
Benzodiazepines MOA
direct skeletal muscle relaxant action in brainstem and spinal cord level. Enhances GABA mediated inhibition.
May be useful for muscle spasm and spasticity caused by upper motor neuron disorder.
What is the only Benzo for muscle spasms
Diazepam (Valium)
a2-adrenergic Receptor Angonist- Tizanidine (zanaflex) MOA
is related to clonidine and has central mediated myospasmolytic action. Lowers gastric acid secretion. Effective for both CNS and non CNS spasms.
GABA receptor Stimulant (Baclofen) MOA
is only for muscle spasm caused by CNS disease
What to tx short term low back pain
NSAIDS are effective with acetaminophen and skeletal muscle relaxants
What is first line muscle relaxant
Cyclobenzaprine (CAS)- central acting sedative
Tx for acute injury
rest and ice for 24-48 hours
Treat chronic muscle spasm with
PT
Skeletal muscle relaxants should not be used for longer than _____
2 weeks
Always do what before providing tx for any back injury
do rectal exam
What is the only drug with direct muscle relaxant effects
diazepam
Use short term because of abuse potential
Monitor patient while on these drugs for
watch for reduction in spasms
sedation and dizziness
Abuse or abuse potential
give in limited amounts
Monitor LFTs in pts at risk
Geriatrics and these meds
increased risk of sedation
increase risk of falls
driving can make LBP worse, use lumbar supporst
Safety and these drugs in children under 12 and pregnancy
not been established
Patient education
may cause sedation and decrease mental alertness
do not drink ETOH or other CNS depressants due to addictive effects
notify md of skin rash or jaundice
Tizanidine and acetaminophen
Tizanidine and Cipro
Tizanidine and fluvoxamine
Tizanidine and ETOH
delays action of acetaminophen
Cipro may increase levels of Tizanidine. concurrent use is not advised
fluvoxamine may increase risk of Tizanidine
ETOH enhances blood levels of tizanidine
Drugs such as ketoconazole, norfloxacin, ofloxacin, and rofecoxib are ______ with all of these type of drugs
contradicted
Author
Corissa.Stovall
ID
244183
Card Set
Muscle relaxants.txt
Description
Week 11
Updated
2013-10-31T20:30:10Z
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