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Muscle Relaxants

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					Muscle Relaxants
           Muscle Spasms
• Afferent pain due to spasticity
  increases the efferent response
• Causes?
  – Fatigue
  – Dehydration
  – Electrolyte imbalace
       Spasms & Spasticity
• Spasms                   • Spasticity
  – Most common in           – Rigidity of the
    athletics                  muscle
  – Due to muscle trauma     – Due to CNS
  – Pain-spasm-pain            dysfunction
    cycle                    – Exaggerated stretch
  – Results in loss of         reflex
    ROM                      – Often seen in
  – Loss of function           cerebral palsy
  – Possible tissue
    damage
    Malignant Hyperthermia
• Usually seen in athletes
  participating in hot/humid
  environments
• Increased tissue damage due to
  dehydration
  – Cell damage due to calcium imbalance
  – TX – similar to EHI exhaustion/stroke
                 Sources
• OTC
• Prescription

• Indications
  – Pain reduction
  – Muscle spasms
  – Aid with intubation
       Centrally - Acting
• Centrally Acting
  – Depress reflex impulse conduction within
    SC
  – Dec. # of impulses (CNS) avail. to
    produce contract
  – Inhibits reflexes at the spinal level
  – Do not alter function of skeletal muscle
    fibers
  – Typically used with analgesics
       Drugs Used for Spasms
• Examples
  –   Skelaxin, Parafon Forte
  –   Valium*
  –   Sedative effect often seen
  –   Never combine with alcohol


• Table 4-1 pg. 58
               Administration
•   Oral or Parentally
•   Metabolized
•   Excreted
•   Adverse Reactions
    –   Dizzy
    –   Blurred vision
    –   Lethargic
    –   Decreased alertness
       Peripherally Acting
• Inhibit contraction at the NMJ
• Inhibit neuromuscular function
  – Nondepolarizing blockers – prevent ACH
    from combining with receptors
  – Depolarizing blockers
    • Attaches to NII receptors = depolarization
    • Alters NII receptors; cannot respond to ACH
     stim
           Administration
• Nondepolarizing – IV
• Depolarizing – IV
• Adverse Effects
  – Paralysis of respiratory muscles
  – Muscle paralysis
  – Malignant hyperthermia – drastic BT inc,
    shock, acidosis, electrolyte imbalance
• Indications - surgery
      Contraindications/Adverse
               Effects
•   Drowsiness
•   Decreased reaction time/balance
•   Addictive
•   What happens when combined with:
    – alcohol: sedative effect
    – Antihistamines: CNS depression
    – Highly abused drugs
                Final Word
• RX drugs should be the last resort
• Use other means of therapy
  –   TENS
  –   Thermal Therapy
  –   Massage
  –   Joint Mobes

				
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posted:10/26/2011
language:English
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