Baclofen in the Treatment of Spinal Cord Injuries: Difference between revisions
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'''Baclofen''' | '''Baclofen''' | ||
Baclofen, commonly known as Kemstro or Lioresal, acts as an allosteric modulator to GABA b receptors. This leads to the inhibition of alpha motor neurons within the spinal cord. Pre- and postsynaptic inhibition leads to reduction in skeletal muscle tone | Baclofen, commonly known as Kemstro or Lioresal, acts as an allosteric modulator to GABA b receptors. This leads to the inhibition of alpha motor neurons within the spinal cord. Pre- and postsynaptic inhibition leads to reduction in skeletal muscle tone<ref name=":0">[[Ciccone, C. D. (2016). Pharmacology in rehabilitation (5th ed.). Philadelphia: F.A. Davis Company.]] | ||
</ref><ref name=":1">Shukla, Lekhansh, et al. “Baclofen in the Short-Term Maintenance Treatment of Benzodiazepine Dependence.” Journal of Neurosciences in Rural Practice, vol. 5, no. 5, 2014, p. 53., doi:10.4103/0976-3147.145203.</ref> Weak permeability to the blood-brain barrier makes | </ref><ref name=":1">Shukla, Lekhansh, et al. “Baclofen in the Short-Term Maintenance Treatment of Benzodiazepine Dependence.” Journal of Neurosciences in Rural Practice, vol. 5, no. 5, 2014, p. 53., doi:10.4103/0976-3147.145203.</ref>. Weak permeability to the blood-brain barrier makes baclofen more effective in treating spasticity at the level of the spinal cord. In addition, baclofen does not cause the type of generalized muscle weakness seen with dantrolene<ref name=":1" />. | ||
Intrathecal administration utilizes a surgically implanted catheter connected to a pump that delivers the drug into the subarachnoid space, around the level of the lesion, allowing for higher efficacy through smaller dosages. Initial adult dose is 5 mg and increased by 5 mg at 72-hour intervals, up to 80 mg/day <ref name=":0" />. There is no specific pediatric dose, the dose is calculated by the child’s size and weight. The half-life ranges between 2.5-4 hours, and the rate of clearances is 4-8 hours according to the patient's metabolic rate. | Intrathecal administration utilizes a surgically implanted catheter connected to a pump that delivers the drug into the subarachnoid space, around the level of the lesion, allowing for higher efficacy through smaller dosages. Initial adult dose is 5 mg and increased by 5 mg at 72-hour intervals, up to 80 mg/day <ref name=":0" />. There is no specific pediatric dose, the dose is calculated by the child’s size and weight. The half-life ranges between 2.5-4 hours, and the rate of clearances is 4-8 hours according to the patient's metabolic rate. The main adverse effects to look for are nausea, dizziness, drowsiness, fatigue, and weakness<ref name=":0" /><ref name=":1" />. | ||
Monitoring medication specific CNS symptoms such as seizures and nausea | Monitoring medication specific CNS symptoms, such as seizures and nausea, are important for maintaining patient safety. Similar to benzodiazepines, withdrawal symptoms can occur when discontinuing the drug<ref name=":1" />. Scheduling therapy sessions according to the drug therapeutic index is necessary as baclofen acts as an alternative to other sedative-hypnotics<ref name=":0" /><ref name=":1" />. For patients with an intrathecal delivery system, pump placement and overall knowledge of the pump is important to ensure safety through interventions. | ||
== Back to [[Pharmacological Management of Spinal Cord Injuries]]. == | == Back to [[Pharmacological Management of Spinal Cord Injuries]]. == | ||
<references /> | <references /> | ||
Revision as of 19:20, 30 November 2018
Baclofen
Baclofen, commonly known as Kemstro or Lioresal, acts as an allosteric modulator to GABA b receptors. This leads to the inhibition of alpha motor neurons within the spinal cord. Pre- and postsynaptic inhibition leads to reduction in skeletal muscle tone[1][2]. Weak permeability to the blood-brain barrier makes baclofen more effective in treating spasticity at the level of the spinal cord. In addition, baclofen does not cause the type of generalized muscle weakness seen with dantrolene[2].
Intrathecal administration utilizes a surgically implanted catheter connected to a pump that delivers the drug into the subarachnoid space, around the level of the lesion, allowing for higher efficacy through smaller dosages. Initial adult dose is 5 mg and increased by 5 mg at 72-hour intervals, up to 80 mg/day [1]. There is no specific pediatric dose, the dose is calculated by the child’s size and weight. The half-life ranges between 2.5-4 hours, and the rate of clearances is 4-8 hours according to the patient's metabolic rate. The main adverse effects to look for are nausea, dizziness, drowsiness, fatigue, and weakness[1][2].
Monitoring medication specific CNS symptoms, such as seizures and nausea, are important for maintaining patient safety. Similar to benzodiazepines, withdrawal symptoms can occur when discontinuing the drug[2]. Scheduling therapy sessions according to the drug therapeutic index is necessary as baclofen acts as an alternative to other sedative-hypnotics[1][2]. For patients with an intrathecal delivery system, pump placement and overall knowledge of the pump is important to ensure safety through interventions.
Back to Pharmacological Management of Spinal Cord Injuries.[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 Ciccone, C. D. (2016). Pharmacology in rehabilitation (5th ed.). Philadelphia: F.A. Davis Company.
- ↑ 2.0 2.1 2.2 2.3 2.4 Shukla, Lekhansh, et al. “Baclofen in the Short-Term Maintenance Treatment of Benzodiazepine Dependence.” Journal of Neurosciences in Rural Practice, vol. 5, no. 5, 2014, p. 53., doi:10.4103/0976-3147.145203.
