Centrally Acting Skeletal Muscle Relaxants and Their Indications
中枢作用性骨骼肌松弛药及其适应症
Centrally acting skeletal muscle relaxants include baclofen (Lioresal), carisoprodol (Soma), chlorzoxazone (Parafon), cyclobenzaprine (Amrix), metaxalone (Skelaxin), methocarbamol (Robaxin), orphenadrine (Banflex, Flexon), and tizanidine (Zanaflex). Diazepam (Valium), a drug widely used as an anxiety agent, also has been shown to be an effective centrally acting skeletal muscle relaxant. It may be advantageous in situations in which anxiety may be precipitating the muscle spasm.
Other measures in addition to these drugs should be used to alleviate muscle spasm and pain. Such modalities as rest of the affected muscle, heat applications to increase blood flow to the area to remove the pain-causing chemicals, physical therapy to return the muscle to normal tone and activity, and anti-inflammatory agents—including nonsteroidal anti-inflammatory drugs (NSAIDs)—if the underlying problem is related to injury or inflammation may help.
The centrally acting skeletal muscle relaxants work in the CNS to interfere with the reflexes that are causing the muscle spasm. Because these drugs lyse or destroy spasm, they are often referred to as spasmolytics. Although the exact mechanism of action of these skeletal muscle relaxants is not known, it is thought to involve action in the upper or spinal interneurons. Tizanidine is an alpha-adrenergic agonist and is thought to increase inhibition of presynaptic motor neurons in the CNS. The primary indication for the use of centrally acting skeletal muscle agents is the relief of discomfort associated with acute, painful musculoskeletal conditions as an adjunct to rest, physical therapy, and other measures. Because these drugs work in the upper levels of the CNS, possible depression must be anticipated with their use.
baclofen – n. 巴氯芬
Lioresal – n. 力奥来素
carisoprodol – n. 卡立普多
Soma – n. 【奥】索玛（卡立普多片
chlorzoxazone – n. 氯唑沙宗
Parafon – n. 帕拉芳
cyclobenzaprine – n. 环苯扎林
Amrix – n.【奥】阿莫瑞克
metaxalone – n. 美他沙酮
Skelaxin – n. 弛可利痉
methocarbamol – n. 美索巴莫
Robaxin – n. 舒筋灵
orphenadrine – n. 奥芬那君
Banflex – n.【奥】斑弗雷克
Flexon – n.【奥】弗雷克松
tizanidine – n. 替扎尼定
Zanaflex – n.【奥】扎那弗雷
modality – n. 物理疗法，方式
lyse – v. 细胞溶解，溶化
spasmolytic – n. 解痉剂
adjunct – n. (to)附属物，附加 （注：单词标【奥】者为本站临时名称，只供读者方便记忆用，不得作为临床诊治依据）
1. All of the following are direct-acting skeletal muscle relaxants, except:
A. Botulinum toxin type A
B. Myobloc
C. Dantrium
D. None of the above 1. Answer: D. None of the above.
Botulinum toxin type A (Botox Cosmetic), botulinum toxin type B (Myobloc), and dantrolene (Dantrium) are all direct-acting skeletal muscle relaxants. 2. Which of the following is the priority nursing intervention for children receiving muscle relaxants?
A. Assess bowel sounds and activity.
B. Provide skin care.
C. Administer drug with food.
D. Both A and B. 2. Answer: A. Assess bowel sounds and activity.
Children are especially at an increased risk of CNS and GI toxicity.
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答案 Answers
1. D. None of the above. Rationale: Botulinum toxin type A (Botox Cosmetic), botulinum toxin type B (Myobloc), and dantrolene (Dantrium) are all direct-acting skeletal muscle relaxants. 2. A. Assess bowel sounds and activity. Rationale: Children are especially at an increased risk of CNS and GI toxicity.
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