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Unit III: The Nervous System

Muscle Spasms. Involuntary contraction of a muscle or group of muscles."Associated with:Overuse or local skeletal muscle injuryOvermedication with antipsychoticsOther conditions or disordersTypes:TonicClonic . Treatment. Pharmacologic. AnalgesicsAnti-inflammatory agentsCentrally acting sk

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Unit III: The Nervous System

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    1. Unit III: The Nervous System Chapter 21: Drugs for Neuromuscular Disorders

    2. Muscle Spasms “Involuntary contraction of a muscle or group of muscles.” Associated with: Overuse or local skeletal muscle injury Overmedication with antipsychotics Other conditions or disorders Types: Tonic Clonic

    3. Treatment Pharmacologic Analgesics Anti-inflammatory agents Centrally acting skeletal muscle relaxants Nonpharmacologic Immobilization (rest) Heat or cold applications Hydrotherapy Ultrasound Supervised exercise Massage Manipulation

    4. Centrally Acting Skeletal Muscle Relaxants Action: Exact mechanism unknown; believed to inhibit upper motor neuron activity within brain and spinal cord Examples: baclofen (Lioresal) metaxalone (Skelaxin) tizanidine (Zanaflex Prototype: cyclobenzaprine (Flexeril) p. 277 Adverse effects: Drowsiness, dizziness, dry mouth, sedation, ataxia, light-headedness, urinary hesitancy or retention, hypotension, bradycardia

    5. Two Common Medications baclofen (Lioresal) structurally similar to GABA, inhibits neuron activity with the brain and maybe the spinal cord. Often first choice drug Common side effects: Drowsiness, dizziness, weakness and fatigue tizanidine (Zanaflex) Centrally acting alpha2-adrenergic agonist that inhibits motor neurons mainly at level of spinal cord Rare: hallucinations Common side effects: Dry mouth, fatigue, dizziness, sleepiness

    6. Benzodiazepines Why would benzodiazepines be used to treat muscle spasticity? When is the use of benzodiazepines indicated? Why are they not considered first choice drugs?

    7. Spasticity “condition in which certain muscle groups remain in a continuous state of contraction…” What is the most common cause of spasticity? What motor neurons are damaged? What is the characteristic symptom of spasticity? What other symptoms are experienced with spasticity?

    8. Treatment for Spasticity Combination of pharmacotherapy and physical therapy Antispasmotics Surgery indicated in extreme cases

    9. Direct Acting Antispasmotics Action: Will either block release of Ach (neuromuscluar junction) or block calcium release within muscles Examples: botulinum toxin A (Botox) or B (Myobloc) quinine sulfate (Quinamm) Prototype: dantrolene (Dantrium) p. 279 Adverse effects: botulinum: extreme weakness dantrolene: muscle weakness, drowsiness, dry mouth, dizziness, n/v, diarrhea, tachycardia, erratic BP, photosensitivity, urinary retention

    10. Nursing Considerations What is the role of the nurse in antispasmotic therapy? What needs to be included in client teaching?

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