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Related Concept Videos

Spasmolytic Agents: Chemical Classification01:29

Spasmolytic Agents: Chemical Classification

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Spasmolytic agents are drugs used to alleviate muscle spasms and spasticity. They can be categorized into different chemical groups based on their mechanisms of action. Centrally acting spasmolytics primarily affect the spinal cord, while others directly target skeletal muscle cells.
A major class of centrally acting spasmolytics is the α2-agonist, such as tizanidine. These drugs bind to α2-adrenoceptors, inhibiting the release of the excitatory neurotransmitter glutamate. They also...
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Centrally Acting Muscle Relaxants: Therapeutic Uses01:24

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Centrally acting muscle relaxants reduce muscle tone and tension by interfering with the postsynaptic reflexes in the central nervous system.
Centrally acting drugs are classified into spasmolytic and antispasmodic drugs. Spasmolytic drugs such as baclofen, diazepam, and tizanidine inhibit spinal motor neurons and decrease muscle tone. Spasmolytic drugs are administered for severe and chronic spasms due to multiple sclerosis, cerebral palsy, stroke, and spinal cord and muscle injuries. However,...
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Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

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Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
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Classification of Skeletal Muscle Relaxants01:28

Classification of Skeletal Muscle Relaxants

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Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
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Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

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Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
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Peripherally and Centrally Acting Muscle Relaxants: A Comparison01:09

Peripherally and Centrally Acting Muscle Relaxants: A Comparison

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Skeletal muscle relaxants can target the central nervous system [CNS] to reduce muscle tension or act directly at the neuromuscular junction to induce temporary paralysis. These two classes of muscle relaxants are called centrally acting muscle relaxants and peripherally acting muscle relaxants. They differ in their action, mechanism, administration route, and clinical uses.
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic...
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Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale
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Netilmicin-induced carpopedal spasm.

Roja Y Ramani1, Benu Panigrahy2, Bandana Rath1

  • 1Department of Pharmacology, Maharaja Krishna Chandra Gajapati Medical College and Hospital, Berhampur, Odisha, India.

Journal of Pharmacology & Pharmacotherapeutics
|September 12, 2014
PubMed
Summary

Netilmicin, an antibiotic, can cause electrolyte imbalances like hypocalcemia, leading to carpopedal spasm. This highlights the need for monitoring even with newer gentamicin-family drugs.

Keywords:
Carpopedal spasmhypocalcemianetilmicin

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Area of Science:

  • Nephrology
  • Pharmacology
  • Internal Medicine

Background:

  • Aminoglycosides are common antibiotics but can cause kidney damage (nephrotoxicity).
  • Netilmicin, a gentamicin-related antibiotic, is often used for resistant infections and has a lower risk of ototoxicity and nephrotoxicity.
  • Despite its safety profile, netilmicin can still lead to electrolyte disturbances.

Observation:

  • Two patients developed carpopedal spasm, a symptom of low calcium levels (hypocalcemia).
  • This occurred after receiving netilmicin treatment.
  • The hypocalcemia was attributed to the kidneys improperly retaining electrolytes (renal electrolyte wasting).

Findings:

  • Netilmicin use can lead to symptomatic hypocalcemia, hypomagnesemia, and hypokalemia.
  • Renal electrolyte wasting is a potential adverse effect of netilmicin.
  • Carpopedal spasm is a clinical manifestation of netilmicin-induced hypocalcemia.

Implications:

  • Patients treated with netilmicin should be monitored for electrolyte imbalances, particularly calcium, magnesium, and potassium.
  • Early detection and management of electrolyte wasting can prevent serious complications like carpopedal spasm.
  • This case series underscores the importance of vigilance for adverse effects even with antibiotics considered safer.