Open Access Open Access  Restricted Access Subscription Access

The Impact of Drugs on Muscle Relaxants: A Comprehensive Analysis

Muralinath E., Pooja Devi, Prasanta Chbukdhara, Sanjib Borah, Kalyan C., Archana Jain, Guruprasad M.

Abstract


Muscle relaxants ate helpful on decreasing muscle spasms, pain and stiffness also. Muscle relaxants perform by affecting the Central nervous system and decrease nerve impulses that are responsible for causing muscle contractions. Muscle relaxants are frequently prescribed for a very few conditions namely chronic pain, Muscle spasms and certain neurological abnormalities. An example for common Muscle relaxants is baclofenac, cyclobenzaprine and tizanide. If alcohol combines with Muscle relaxants, It can enhance dizziness and drowsiness also. This interaction results in impairment of motor skills and coordination. The combination of opioid and muscle relaxants results in respiratory depression. The combination of tri cycle. Anti-depressants lead to occurrence of an increased sedation due to the effect of nerve impulses in the brain. The combination of benzodiazepines and muscle relaxants results in excessive drowsiness and impaired cognitive function. The combination of NSAID s and muscle relaxants may increase pain relief, but it may cause potential gastro intestinal side effects. Certain herbal supplements namely kava and valerian root show sedative effects and may interact with muscle relaxants. Finally it is concluded that an open communication with health care professionals, adhere to prescribed dosage and vigilant monitoring can help mitigate potential risks linked tovcombing muscle relaxants with ormther compounds.


Full Text:

PDF

References


Borenstein, D. G., & Korn, S. (2003). Efficacy of a low-dose regimen of cyclobenzaprine hydrochloride in acute skeletal muscle spasm: results of two placebo-controlled trials. Clinical therapeutics, 25(4), 1056-1073.

Liu, Y., Qian, C., & Yang, M. (2016). Treatment patterns associated with ACR-recommended medications in the management of fibromyalgia in the United States. Journal of managed care & specialty pharmacy, 22(3), 263-271.

Calandre, E. P., Rico-Villademoros, F., & Slim, M. (2015). An update on pharmacotherapy for the treatment of fibromyalgia. Expert opinion on pharmacotherapy, 16(9), 1347-1368.

Macfarlane, G. J., Kronisch, C., Dean, L. E., Atzeni, F., Häuser, W., Fluß, E., ... & Jones, G. T. (2017). EULAR revised recommendations for the management of fibromyalgia. Annals of the rheumatic diseases, 76(2), 318-328.

Herman, C. R., Schiffman, E. L., Look, J. O., & Rindal, D. B. (2002). The effectiveness of adding pharmacologic treatment with clonazepam or cyclobenzaprine to patient education and self-care for the treatment of jaw pain upon awakening: a randomized clinical trial. Journal of orofacial pain, 16(1).

Sullivan, G. M., Gendreau, R. M., Gendreau, J., Peters, P., Peters, A., Engels, J., ... & Lederman, S. (2021). Randomized clinical trial of bedtime sublingual cyclobenzaprine (TNX-102 SL) in military-related PTSD and the role of sleep quality in treatment response. Psychiatry Research, 301, 113974.

Huang, Z., & Ung, T. (2013). Effect of alpha-1-acid glycoprotein binding on pharmacokinetics and pharmacodynamics. Current drug metabolism, 14(2), 226-238.

Kobayashi, H., Hasegawa, Y., & Ono, H. (1996). Cyclobenzaprine, a centrally acting muscle relaxant, acts on descending serotonergic systems. European journal of pharmacology, 311(1), 29-35.

Witenko, C., Moorman-Li, R., Motycka, C., Duane, K., Hincapie-Castillo, J., Leonard, P., & Valaer, C. (2014). Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain. Pharmacy and therapeutics, 39(6), 427.

Brioschi, T. M. D. L. S., Schramm, S. G., Kano, E. K., Koono, E. E. M., Ching, T. H., Serra, C. H. D. R., & Porta, V. (2013). Pharmacokinetics and bioequivalence evaluation of cyclobenzaprine tablets. BioMed research international, 2013.

Winchell, G. A., King, J. D., Chavez‐Eng, C. M., Constanzer, M. L., & Korn, S. H. (2002). Cyclobenzaprine pharmacokinetics, including the effects of age, gender, and hepatic insufficiency. The Journal of Clinical Pharmacology, 42(1), 61-69.

Owsiany, M. T., Hawley, C. E., Triantafylidis, L. K., & Paik, J. M. (2019). Opioid management in older adults with chronic kidney disease: a review. The American journal of medicine, 132(12), 1386-1393.

Levonorgestrel, I. (2019). Drugs and Lactation Database (LactMed)[Internet]. Bethesda (MD): National Library of Medicine (US), 63-7.15.

Chaffee, D. M. (2016). Medicine by the Numbers: Cyclobenzaprine in the Treatment of Low Back Pain. American Family Physician, 93(3).

Kraus MB, Wie CS, Gorlin AW, Wisenbaugh ES, Kraus, M. B., Wie, C. S., Gorlin, A. W., Wisenbaugh, E. S., & Rosenfeld, D. M. (2015). Painful ejaculation with cyclobenzaprine: a case report and literature review. Sexual medicine, 3(4), 343-345.

Braschi E, Braschi, E., Garrison, S., & Allan, G. M. (2015). Cyclobenzaprine for acute back pain. Canadian Family Physician, 61(12), 1074-1074.

National Institute of Diabetes and Digestive and Kidney Diseases (US). (2012). LiverTox: clinical and research information on drug-induced liver injury. National Institute of Diabetes and Digestive and Kidney Diseases.

Mestres, J., Seifert, S. A., & Oprea, T. I. (2011). Linking pharmacology to clinical reports: cyclobenzaprine and its possible association with serotonin syndrome. Clinical Pharmacology & Therapeutics, 90(5), 662-665.

Bebarta, V. S., Maddry, J., Borys, D. J., & Morgan, D. L. (2011). Incidence of tricyclic antidepressant-like complications after cyclobenzaprine overdose. The American journal of emergency medicine, 29(6), 645-649.

Keegan, M. T., Brown, D. R., & Rabinstein, A. A. (2006). Serotonin syndrome from the interaction of cyclobenzaprine with other serotoninergic drugs. Anesthesia & Analgesia, 103(6), 1466-1468.

Hjermstad, M. J., Fayers, P. M., Haugen, D. F., Caraceni, A., Hanks, G. W., Loge, J. H., ... & European Palliative Care Research Collaborative (EPCRC. (2011). Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. Journal of pain and symptom management, 41(6), 1073-1093.

Ferreira-Valente, M. A., Pais-Ribeiro, J. L., & Jensen, M. P. (2011). Validity of four pain intensity rating scales. Pain®, 152(10), 2399-2404.

Reiter, S., Eli, I., Mahameed, M., Emodi-Perlman, A., Friedman-Rubin, P., Reiter, M. A., & Winocur, E. (2018). Pain catastrophizing and pain persistence in temporomandibular disorder patients. J Oral Facial Pain Headache, 32(3), 309-320.

Morgan, D. J., Dhruva, S. S., Wright, S. M., & Korenstein, D. (2016). 2016 update on medical overuse: a systematic review. JAMA internal medicine, 176(11), 1687-1692.

Siddique, O., Rasla, S., Clark, S., & Kokkirala, A. (2016). A case of ileus and ST segment elevation. Rhode Island Medical Journal, 99(11), 44.

Spiller, H. A., & Cutino, L. (2003). Fatal cyclobenzaprine overdose with postmortem values. Journal of forensic sciences, 48(4), JFS2002308.

Spiller, H. A., Winter, M. L., Mann, K. V., Borys, D. J., Muir, S., & Krenzelok, E. P. (1995). Five-year multicenter retrospective review of cyclobenzaprine toxicity. The Journal of emergency medicine, 13(6), 781-785.

Linden, C. H., Mitchiner, J. C., Lindzon, R. D., & Rumack, B. H. (1983). Cyclobenzaprine overdosage. Journal of Toxicology: Clinical Toxicology, 20(3), 281-288.

Müller, M., Jürgens, J., Redaèlli, M., Klingberg, K., Hautz, W. E., & Stock, S. (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. BMJ open, 8(8), e022202.

Poitras, S., Durand, M. J., Côté, A. M., & Tousignant, M. (2012). Guidelines on low back pain disability: interprofessional comparison of use between general practitioners, occupational therapists, and physiotherapists. Spine, 37(14), 1252-1259.


Refbacks

  • There are currently no refbacks.