McKenna's Pharmacology for Nursing, 2e

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C H A P T E R 2 5 Muscle relaxants

CHAPTER SUMMARY ■■ Upper-level controls of muscle activity include the pyramidal tract in the cerebellum, which regulates coordination of intentional muscle movement, and the extrapyramidal tract in the cerebellum and basal ganglia, which coordinates crude movements related to unconscious muscle activity. ■■ Damage to a muscle or anchoring skeletal structure may result in the arrival of a flood of impulses to the spinal cord. Such overstimulation may lead to a muscle spasm or a state of increased contraction. ■■ Damage to motor neurons can cause muscle spasticity, with a lack of coordination between muscle groups and loss of coordinated activity, including the ability to perform intentional tasks and maintain posture, position and locomotion. ■■ Centrally-acting skeletal muscle relaxants are used to relieve the effects of muscle spasm. Dantrolene, a direct-acting skeletal muscle relaxant, is used to control spasticity and prevent malignant hyperthermia. ■■ Botulinum toxin type A is used to improve the appearance of moderate to severe glabellar lines and to treat cervical dystonia, severe primary axillary hyperhidrosis, and strabismus and blepharospasm associated with dystonia.

WEB LINKS

Healthcare providers and students may want to consult the following Internet sources: www.cerebralpalsy.org.au Home page of the Cerebral Palsy Alliance. Information on research and support services for people with cerebral palsy. www.cpaustralia.com.au Home page of Cerebral Palsy Australia. Information on research and support services for people with cerebral palsy. BIBLIOGRAPHY Aslan, A., Cemek, M., Buyukokuroglu, M. E., Altunbas, K., Bas, O., Yurumez, Y. & Cosar, M. (2009). Dantrolene can reduce secondary damage after spinal cord injury. European Spine Journal, 18, 1442–1451. Bhimani, R. (2008). Intrathecal baclofen therapy in adults and guideline for clinical nursing care. Rehabilitation Nursing, 33(3) , 110–116. Darlington, A. B. (2010). The Botox © phenomenon. Plastic Surgical Nursing, 30(1) , 22–26. Drummer, O. H. (2008). The role of drugs in road safety. Australian Prescriber, 31, 33–35. Farrell, M. & Dempsey, J. (2014). Smeltzer & Bare’s Textbook of Medical-Surgical Nursing (3rd edn). Sydney: Lippincott Williams & Wilkins. Goodman, L. S., Brunton, L. L., Chabner, B. & Knollmann, B. C. (2011). Goodman and Gilman’s Pharmacological Basis of Therapeutics (12th edn). New York: McGraw-Hill. McKenna, L. (2012). Pharmacology Made Incredibly Easy (1st Australian and New Zealand edn). Sydney: Lippincott Williams & Wilkins. McKenna, L. & Mirkov, S. (2014). McKenna’s Drug Handbook for Nursing and Midwifery (7th edn). Sydney: Lippincott Williams & Wilkins. Mitchell-Brown, F. (2012). Malignant hyperthermia: Turn down the heat. Nursing, 42(5) , 38–45. Porth, C. M. (2011). Essentials of Pathophysiology: Concepts of Altered Health States (3rd edn). Philadelphia: Lippincott Williams & Wilkins. Porth, C. M. (2009). Pathophysiology: Concepts of Altered Health States (8th edn). Philadelphia: Lippincott Williams & Wilkins. Scheinberg, A. (2009). Clinical use of botulinum toxin. Australian Prescriber, 32, 39–42.

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ONLINE RESOURCES

An extensive range of additional resources to enhance teaching and learning and to facilitate understanding of this chapter may be found online at the text’s accompanying website, located on thePoint at http://thepoint.lww.com. These include Watch and Learn videos, Concepts in Action animations, journal articles, review questions, case studies, discussion topics and quizzes.