Skeletal muscle relaxants uses and side effects.

1. Skeletal Muscle Relaxants Uses, Efficacy, and Side Effects
Skeletal muscle relaxants are a heterogeneous
group of medications. As a class, they are
structurally and pharmacologically diverse. Muscle
relaxants are used to treat two different types of
underlying conditions:
spasticity from upper motor neuron syndromes
muscular pain or spasms from peripheral
musculoskeletal conditions
Although muscle relaxants have by convention been classified into one
group, the Food and Drug Administration (FDA) has approved only a few
medications in this class for treatment of spasticity. The remainder are approved
for treatment of musculoskeletal conditions.
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Muscle relaxants for treatment of spasticity
Spasticity is a state of increased muscular tone with exaggeration of the
tendon reflexes. Some of the more common conditions associated with
spasticity and requiring treatment include multiple sclerosis, spinal cord injury,
traumatic brain injury, cerebral palsy, and poststroke syndrome. In many
patients with these conditions, spasticity can be disabling and painful with a
marked effect on functional ability and quality of life.
The upper motor neuron syndrome is a complex of signs and symptoms
that can be associated with exaggerated cutaneous reflexes, autonomic
hyperreflexia, dystonia, contractures, paresis, lack of dexterity, and fatigability.
Spasticity from the upper motor neuron syndrome can result from a variety of
conditions affecting the cortex or spinal cord.
Muscle relaxants for treatment of musculoskeletal conditions
Muscle spasm is defined as a sudden involuntary contraction of one or
more muscle groups and is usually an acute condition associated with muscle

2. strain (partial tear of a muscle) or sprain (partial or complete rupture of a
ligament). Common musculoskeletal conditions causing tenderness and muscle
spasms include fibromyalgia, tension headaches, myofascial pain syndrome,
and mechanical low back pain or neck pain. If muscle spasm is present in these
conditions, it is related to local factors involving the affected muscle groups.
Efficacy
Most studies have shown the skeletal muscle relaxants to be more
effective than placebo in the treatment of acute painful musculoskeletal
disorders and muscle spasm, while efficacy was less consistent when treating
chronic disorders. When muscle relaxants were used alone, they were not
consistently superior to simple analgesics in relieving pain. When the skeletal
muscle relaxants were used in combination with analgesics, pain relief is superior
to either agent used alone. Studies have suggested that these drugs are
effective, have tolerable side effects, and can be an adjunct in the treatment
of painful musculoskeletal conditions with associated muscle spasm.
No studies have documented superior efficacy of one skeletal muscle
relaxant over another.
SideEffectsandAdversereactions
All skeletal muscle relaxants may cause sedation (drowsiness, dizziness).
Also they can cause severe central nervous system depression with
cardiovascular collapse and respiratory failure.
Some have a potential for hepatotoxicity. Overt hepatitis has been most
frequently observed between the third and twelfth months of therapy. Risk
of hepatic injury appears to be greater in women, in patients over 35 years
of age and in patients taking other medications.
Some of them have potential for dependence and withdrawal symptoms.
Also may have some toxicity in overdose and in combination with other
substances.
Some of them may cause low blood pressure, but this may be controlled by
starting with a low dose and increasing it gradually. The drug may rarely
cause liver damage.
Causes harmless color changes in urine - orange or reddish-purple. The urine
will return to its normal color when the patient stops taking the medicine.
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