Disorders of Skeletal Muscle Responding to (Drug) Therapy

• Myasthenia gravis: muscle weakness due to autoimmune disease affecting the neuromuscular transmission mechanism (use anticholinesterases= oral manifestations)
• Spasticity of Cerebral Palsy: usually dental care is performed in a hospital (use dantrolene, baclofen)
• Congenital Myotonia: sarcolemma membrane is excitable and depolarizes causing contraction of muscles (rare) (Hyperexcitable sarcolemal membrane)
• Tetany: hypocalcemia, muscle goes into contractions (best tx is to correct electrolytes: give Ca⁺⁺ through diet or i.v. if an emergency)
• Laryngospasm: very rare but frightening, various causes including the use of ACE inhibitors (emergency use: neuromuscular blocker: very last resort, must be trained as an anesthesiologist to use this)
• Muscle rigidity in Malignant Hyperthermia: rare, precipitated by general anesthetics (use dantrolene)
• Muscle spasm of unknown origin: stiff neck, low back pain, etc.; low back pain is the 2^nd most common reason to see an MD (#1 is sinusitis) (use diazepam, carisoprodol, cyclobenzapine)
• Flacid Paralysis: polio, multiple sclerosis (experimental tx: snake venom, exotic but with the advent of worldwide polio vaccine, polio is pretty much a non-issue)
• Torticollis: head turned violently, pt cant straighten out (cause unknown)

Category: Pharmacology Notes