Diazepam muscle spasms

The exact mode of action of diazepam (Valium), an antianxiety drug (see Chap. 30), in die relief of painful musculoskeletal conditions is unknown. The drug does have a sedative action, which may account for some of its ability to relieve muscle spasm and pain. 

The skeletal muscle relaxants are contraindicated in patients with known hypersensitivity. Baclofen is contraindicated in skeletal muscle spasms caused by rheumatic disorders. Carisoprodol is contraindicated in patients with a known hypersensitivity to meprobamate. Cyclobenzaprine is contraindicated in patients with a recent myocardial infarction, cardiac conduction disorders, and hyperthyroidism, hi addition, cyclobenzaprine is contraindicated within 14 days of the administration of a monoamine oxidase inhibitor. Oral dantrolene is contraindicated in patients with active hepatic disease and muscle spasm caused by rheumatic disorders and during lactation. See Chapter 30 for information on diazepam. 

Diazepam is used for the control of anxiety and tension, the relief of muscle spasms, and the management of acute agitation during alcohol withdrawal, but it itself may be habit-forming. Chlordiazepoxide has similar uses and its synthesis is somewhat analogous to diazepam. Flurazepam is a hypnotic, useful for insomnia treatment. It is reported to provide 7-8 hr of restful sleep. 

Muscle relaxant As an adjunct for the relief of skeletal muscle spasm because of reflex spasm caused by local pathology, spasticity caused by uppermotor neuron disorders, athetosis, stiff-man syndrome, used parenterally in the treatment of tetanus (diazepam). 

An adjunct for the relief of skeletal muscle spasm caused by reflex spasm to local pathology (such as inflammation of the muscles or joints, or secondary to trauma) spasticity caused by upper motor neuron disorders athetosis stiff-man syndrome. Injectable diazepam may also be used as an adjunct in tetanus. 

Diazepam (Valium, Diastat) [C-IVj [Anxiolytic, Skeletal Muscle Relaxant, Anticonvulsant, Sedative/Hypnotic/ Benzodiazepine] Uses Anxiety, EtOH withdrawal, muscle spasm, status epilepticus, panic disorders, amnesia, preprocedure sedation Action Benzodiazepine Dose Adults. Status epilepticus 5-10 mg IV/IM Anxiety 2-5 mg IM/IV Preprocedure 5-10 mg IV just prior to procedure Peds. Status epilepticus 0.5-2 mg IV/IM Sedation 0.2-0.5 mg/kg IV (onset w/in 5IV and 30 min IM duration about 1 h IV and IM) Caution [D, / -] Contra Coma, CNS depression, resp d es-sion, NAG, severe uncontrolled pain, PRG Disp Tabs 2, 5, 10 mg soln 1, 5 mg/mL inj 5 mg/mL rectal gel 2.5, 5, 10, 20 mg/mL SE Sedation, amnesia, bradycardia, i BP, rash, X resp rate Interactions T Effects W/ antihistamines, azole antifungals, BBs, CNS depressants, cimetidine, ciprofloxin, disulfiram, INH, OCP, omeprazole, phenytoin, valproic acid, verapamil, EtOH, kava kava, valman T effects OF digoxin, diuretics X effects w/ barbiturates, carbamazepine. 

Benzodiazepines have the capacity to depress polysynaptic reflexes and have been shown to decrease decerebrate rigidity in cats and spasticity in patients with cerebral palsy. What is not clear is whether they can, in humans, relax voluntary muscles in doses that do not cause considerable central nervous system depression. Nevertheless, benzodiazepines, such as diazepam, are often prescribed for patients who have muscle spasms and pain as a result of injury. In these circumstances, the sedative and anxiolytic properties of the drug also may promote relaxation and relieve tension associated with the condition. 

Clinical trials with oral tizanidine report comparable efficacy in relieving muscle spasm to diazepam, baclofen, and dantrolene. However, tizanidine produces a different spectrum of adverse effects, including drowsiness, hypotension, dry mouth, and asthenia. The dosage requirements vary markedly among patients, and individual dosage titration is necessary to achieve an optimal clinical effect. 

Among the various other types of epilepsy are partial seizures which involve some involuntary muscle spasm or sensual disturbance without loss of consciousness. Phenobarbital, diazepam, phenytoin and carbamazepine are the most commonly used medications for this condition. As... 

Uses. Diazepam is one of the oldest medications for treating muscle spasms, and has been used extensively in treating spasms associated with musculoskeletal injuries such as acute low-back strains. Diazepam has also been used to control muscle spasms associated with tetanus toxin the use of valium in this situation can be life-saving as well by inhibiting spasms of the larynx and other muscles.51,65... 

As indicated earlier, diazepam is effective in reducing spasticity as well as muscle spasms because this drug increases the inhibitory effects of GABA in the CNS. 

Diazepam is used for the control of anxiety and tension, the relief of muscle spasms, and the management of acute agitation during alcohol withdrawal, but it may be habit forming. 

Muscular disorders Diazepam is useful in the treatment of skeletal muscle spasms such as occur in muscle strain, and in treating spasticity from degenerative disorders, such as multiple sclerosis and cerebral palsy. 

It turned out that the nearly discarded substance had a novel structure, 5, a chlordiazepoxide. It was developed further and became known under the trade name Librium , which was the first antianxiety agent. Librium became the lead compound for the development of many other compounds with related structures. The best known is the diazepam Vh/ium , 6, a tranquilizer used to treat anxiety, muscle spasm, and symptoms of epilepsy. Today, about 40 diazepines are in the market. Nearly forgotten on the laboratory shelf, Librium and Valium became blockbuster drugs that fueled the growth of the Roche company. (Drugs are called blockbusters when sales are much higher than US 1 billion per year.)... 

Urinary frequency, urgency and incontinence flavoxate, tolterodine, oxybutynin (antimuscarinics) may be useful they may cause retention of urine if there is anatomical obstruction. The pain (with reflex muscle spasm) of an indwelling catheter may be alleviated by diazepam. 

Fryda-Kaurimsky Z, Muller-Fassbender H. Tizanidine (DS 103-282) in the treatment of acute paravertebral muscle spasm a controlled trial comparing tizanidine and diazepam. J Int Med Res 1981 9(6) 501-5. 

Goei HS, Whitehouse IJ. Acomparative trial of tizanidine and diazepam in the treatment of acute cervical muscle spasm. Clin Trials J 1982 19 20. 

Diazepam can be used to reduce muscle spasm of any origin including local muscle strain (Miller 1995). The dose rate for the use of diazepam as a minor tranquillizer in horses is 0.01-0.04mg/kg i.v. (Muir Hubbell 1989). Diazepam may cause muscle fasciculation, weakness and ataxia in horses when used at doses sufficient to cause sedation, the doses required to produce reduced muscle tone. Doses of greater than 0.2mg/kg may induce recumbency (Plumb 1995). 

The CNS contains a wide variety of neurotransmitters and high concentrations of receptors. Mechanisms of action of many drugs are often complex combinations of receptor-based actions. Some of the most widely used (and abused) drugs are hypnotics/sedatives, for treatment of insonmia. Barbiturates such as amylo-barbitone have been used for many years, but suffer from side-effects and are addictive. Thiopentone sodium salt (sodium pentothal), however, is very useful as a short-acting intravenous anaesthetic. The benzodiazepines, such as diazepam (Valium) and alprazolam (Xanax), are safer drags for insomnia and also can be used for treatment of anxiety and muscle spasms. Zolpidem (Ambien) is a newer and more selective hypnotic. 

Diazepam is useful in the short-term therapy of anxiety, and in the relief of skeletal muscle spasm as seen with upper motor neuron disorders (e.g., cerebral palsy, athetosis). It may also be of use in alcohol withdrawal, in the symptomatic relief of acute agitation, tremor, and impending acute delirium tremens. 

Cyclobenzaprine is likely to diy oropharyngeal secretions and to decrease gut motility Dantrolene has little effect on calcium release in cardiac muscle Diazepam causes sedation at most doses required to reduce muscle spasms Intrathecal use of baclofen is effective in some refractory cases of muscle spasticity... 

Diazepam (Valium), a benzodiazepine, to a client with muscle spasms. 

A. Control of painful muscle spasm caused by black widow spider envenoma-tion (see p 346). Methocarbamol should be used as an adjunct to other medications (eg, morphine, diazepam) that are considered more effective. 

---