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18 Cards in this Set
- Front
- Back
Name the main non-benzodiazepine skeletal muscle relaxants
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Cyclobenzaprine
Tizanidine Metaxolone Methocarbamol |
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What is the indication for using non-benzodiazepine skeletal muscle relaxants?
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Short term, when acetaminophen or NSAID therapy fails.
You can also use them as adjunctive therapy to NSAIDs. |
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Which two agents are sedating? Which two agents are less sedating?
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Cyclobenzaprine/Tizanidine
Metaxolone/Methocarbamol |
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What is the dose of Cyclobenzaprine and major adverse effects?
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5 mg po Tid
Anti-cholinergic effects (Drowsiness, dry mouth, urinary retention, increased intraocular pressure) |
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What is the dose of Tizanidine and major adverse effects?
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4 mg po daily
Hypotension, sedation, dry mouth Hepatotoxicity ***Tizanidine has both anti-spasmodic and anti-spastic properties*** |
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What is the dose and major adverse effects of Metaxolone?
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800 mg po Tid
Minimal side effects, but no recommended in patients with hepatic, renal failure or a history of anemia ***This drug isn't really much better than placebo*** |
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What is the dose and major adverse effects of Methocarbamol?
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500 mg po Tid
Sedation, Dizziness, Drowsiness |
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In what patients do you want to avoid Cyclobenzaprine?
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Eldery
Glaucoma Patients taking Tramadol (Seizures) Cardiovascular disease (CHF, Recent MI, Arrhythmia) |
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Why has Carisoprodol fallen out of favor?
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Because of its abuse potential
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In selecting an agent to treat back pain (who has failed NSAID therapy) in a normal healthy patient, which two agents would be best?
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Either Cyclobenzaprine or Methocarbamol
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What NSAID would you want to choose in combination?
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You could do Ibuprofen 800 mg Tid
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How would you counsel this patient?
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Warn about drowsiness and sedation, especially in combination with alcohol or opiods
Caution taking before operating machinery. Should see relief in 1-4 days - Not recommended for more than 2 weeks |
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How would you monitor for efficacy and toxicity?
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Efficacy - Pain
Toxicity - Drowsiness, sedation |
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What is the difference in action between anti-spastic agents like Baclofen and the anti-spasmodic agents?
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Anti-spastic agents work at the level of the spinal cord to decrease neuronal firing and relax muscles. This is why they are more beneficial in those with spinal cord related injuries.
Anti-spasmodic agents work at the level of the brain stem. |
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What is the dose of Baclofen?
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10 mg po Tid
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Which agent would you go with in a patient who you are concerned about abuse potential with?
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Methocarbamol - Works well with small abuse potential.
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Random Facts:
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Methocarbamol has less dizziness and drowsiness than the other muscle relaxants. It also may change the color of your urine to a brown/green
Cyclobenzaprine is a pregnancy category B, where the rest are pregnancy category C |
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With what drugs do you want to avoid using Tizanidine?
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CYP 1A2 Inhibitors (Ciprofloxacin, Fluvoxamine)
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