Author Question: A patient who has cerebral palsy is beginning to experience spasticity of the muscles in the upper ... (Read 91 times)

rmenurse · **on:** Jul 23, 2018

A patient who has cerebral palsy is beginning to experience spasticity of the muscles in the upper arm. Which medications would the nurse question if prescribed for this patient?

1. Metaxalone (Skelaxin) dosed three times a day
2. Chlorzoxazone (Parafon Forte) dosed four times a day
3. Carisoprodol (Soma) dosed three times a day
4. Intrathecal baclofen (Lioresal)
5. Tizanidine (Zanaflex) dosed twice a day

Question 2

Which statement is correct in regard to the muscle relaxant botulinum toxin type B (Myobloc)?

1. It can be classified as a cholinergic agonist.
2. Increased muscle strength is often seen within a couple of weeks.
3. It can take 6 months for the effects to be seen.
4. In high doses, it is poisonous, causing the same symptoms food poisoning does.

sarajane1989 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1,2,5
Rationale 1: Metaxalone (Skelaxin) is ineffective in the treatment of spasticity-related neurologic disorders.
Rationale 2: Chlorzoxazone (Parafon Forte) is ineffective in the treatment of spasticity related to neurodegenerative disorders.
Rationale 3: Carisoprodol (Soma) is effective in relieving the pain, muscle spasms, and spasticity associated with cerebral palsy and is dosed three times a day.
Rationale 4: Baclofen (Lioresal) is effective in reducing muscle spasticity and can be delivered intrathecally.
Rationale 5: Tizanidine (Zanaflex) is used for muscle spasticity but has a short half-life and must be dosed every 6?8 hours.

Answer to Question 2

Correct Answer: 4
Rationale: Botulinum toxin type B (Myobloc) is toxic in high doses. Clostridium botulinum is the bacteria responsible for food poisoning. The drug works by blocking the release of acetylcholine from cholinergic nerve terminals. It generally takes 6 weeks to see the effects, and they only last for 36 months. Patients taking this drug generally experience muscle weakness, not strength.