Musculature treatments

Juvenile dermatomyositis (JDM) is perhaps the most uniform, in terms of clinical and histopathological features, of the whole PM/DM disease complex. Presentation may be before 5 years of age with peak incidence between 8 and 12 years. The disease may remit and recur until well into young adult life. The skin lesions include a facial rash in butterfly distribution across nose and cheeks. Erythematous skin changes are seen over extensor surfaces of joints, especially knees, knuckles and elbows. Muscle involvement is generally evident some time later and takes the form of weakness and stiffness, particularly affecting shoulder and pelvic musculature. Proximal muscles are often worse affected than distal muscles and extensors worse than flexors. In the absence of prompt and effective treatment contractures may occur at elbows, ankles, knees, and hips. Subcutaneous calcification and skin ulceration may be found calcification of deeper-lying connective tissue may be apparent on X-ray. 

Minoxidil is a peripheral vasodilator that directly relaxes vascular smooth musculature, thus, lowering systolic and diastolic pressure. Its action is linked to the activation of calcium channels. Open calcium channels cause hyperpolarization of smooth muscle cells, which in turn, reduces the flow of calcium ions into the cell, which is necessary for supporting vascular tonicity. However, when taking minoxidil, tachycardia, elevated renin secretion, and water and sodium ion retention all appear simultaneously with hypotension. Because of potentially serious side effects, it is used only for severe hypertension that does not respond to treatment with other drugs, and absolutely in combination with two other antihypertensive drugs. A synonym of this drug is loniten. 

Theophylline reduces contractile activity of smooth musculature, widens bronchi and blood vessels, reduces pulmonary vascular resistance, stimulates the respiratory center, and increases the frequency and power of cardiac contractions. It is used for bronchial asthma, preventing attacks, and systematic treatment. Theophylline is also used for symptomatic treatment of bronchospastic syndrome of a different etiology (chronic obstructive pulmonary disease, chronic bronchitis, and pulmonary emphysema). A large number of combined drags are based on theophylline. Synonyms of theophylline are adophyllin, asthmophyllin, theocin, and many others. 

Myasthenia gravis is an autoimmime disease that affects the neuromuscular junction.A decrease in the number of available acetylcholine receptors due to circulating antibodies results in impaired neuromuscular transmission. This impairment manifests clinically as weakness and fatigability of volimtary musculature. Ocular and other muscles innervated by cranial nerves are most often involved. Although different treatment modalities are available, anticholinesterase drugs remain the mainstay of therapy. 

Muscle mass affects the toxin s response. More toxin is needed locally to produce a desired effect in areas of increased muscle mass. Histologic examination of orbicularis oculi musculature after treatment with botulinum toxin shows no evidence of alteration of muscle fiber diameter, disruption of internal muscle architecture, or pathologic changes in the motor end plates. 

Twice a day, 10 to 15 slow knee-bends (= thigh muscles), plus 10 to 15 times standing on tiptoe (= calf muscles), plus 10 to 15 times upper arm flexing (= biceps), plus 10 to 15 times bending from the waist (= back muscles). This activates >60% of the total musculature on a daily basis without any special effort or expense, i.e. in the home environment, in all weathers . Such regular exercise is essential for both prevention and treatment of osteopathy. 

The uses of neostigmine are similar to those of physostig-mioe but differ in exhibiting greater miotic activity, fewer ind less unpleasant local and systemic manifestations, and treater chemical stability. The most frequent application of neostigmine is to prevent atony of the intestinal, skeletal, and bindder musculature. An important u.sc is in the treatment of... 

With prolonged treatment, as in long-term use of androgens in mammary carcinoma, male pattern baldness, excessive body hair, prominent musculature, and hypertrophy of the clitoris may develop and may be irreversible. Patients receiving the 17a-alkyl substituted androgens may develop hepatic adenocarcinoma, the complications may be more common in people with Fanconi s anemia. 

Answer D. Praziquantel is the drug of choice for treatment of all fluke (trematode) infections and most tapeworm (cestode) infections. Its antihelminthic action derives from an increase in membrane permeability to Ca, which results in contraction, followed by paralysis, of worm musculature. Mebendazole also has antihelminthic activity, hut it is restricted to the nematodes. The other drugs listed are antiprotozoals. 

Benzyl(tetrahydro)isoquinoline alkaloids. B. a. occur especially in various Annonaceae, Lauraceae, Rhamnaceae, Ranunculaceae, Papaveraceae, and Fa-baceae. They are soluble in ethanol, chloroform, ether and poorly soluble in water. Laudanidine is toxic, it acts as a convulsive and respiratory stimulant, laudan-osine is a tetanic toxin, orientaline is the biosynthetic precursor of isothebaine. Pwtosinomenine occurs especially in Erythrina lithosperma (Fabaceae). Papaverine [ 1 -(3,4-dimethoxybenzyl)-6,7-dimethoxyiso-quinoline] acts as a parasympathicolyticum relaxing smooth musculature, it promotes cerebral perfusion (vasodilatation). It is an antiasthmatic and oral anti-spasmodic agent used in the treatment of gastrointestinal spasms LD50 (mouse i. v.) 25 mg/kg. Reticuline is an important precursor of protoberberines, morphi-nans, aporphines, spirobenzylisoquinolines, and rhoeadine alkaloids. 

The cervical region musculature is commonly involved in stress-related reactions. During times of stress, individuals tend to tense the neck and upper back muscles, elevate the shoulders, and as a result have pain and stiffness of the neck and upper back. Some patients tend to "carry the weight of the world on their shoulders, and the trapezius tenses. Often, tender points and trigger points develop in this muscle. Trigger points in the trapezius usually refer pain to the head. Teaching the patient techniques to cope with stress is important in the treatment of stress-related somatic dysfunctions. 

Nervous system A randomised, double-blind, crossover study of 12 healthy adults with risperidone demonstrated significant dose-dependent effects on balance control. This effect was observed at low doses with no clinically detectable extrapyramidal symptoms [249 -]. Pisa syndrome is a dystonia affecting cervical and lumbar musculature that has been reported with risperidone, paliperidone and chlorpromazine. A case is presented of a 31-year-old male with MS and FDD who developed Pisa syndrome after chronic risperidone treatment showed improvement with lurasidone, but recurrence with chlorpromazine [250 ]. Another case in a 23-year-old female with history of seizure due to periventricular focal nodular heterotopia occurring 12 months after risperidone treatment she was eventually managed on olanzapine and baclofen PSI ]. A case of persistent Parkinsonism in an 84-year-old male after 5 months of risperidone (2 mg per day) is reported [252 ]. Other dystonic phenomena reported with risperidone include dislocation of the temporomandibular joint [253 ]. 

---