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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 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 Drowsiness Insomnia Dizziness Weakness 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 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 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 Rashes Syncope Headaches Hot, Flushed Skin Ringing In The Ears 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