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MUSCLE RELAXANTSMUSCLE RELAXANTS

SPASMOLITICSPASMOLITIC

OlehOleh

Wiwik KusumawatiWiwik Kusumawati

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 A CASE

 A 25-year-old paraplegic man whohad sustained a T3/T4 erte!ralcompression "racture 3 years

preiously presented with seere#pain"ul spasm o" the le"t hamstringmuscle group o" 2 hours$ duration%

This spasm produced e&treme knee'e&ion o" a degree which held the le"t"oot posterior to the right !uttock%

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SPASMOLITIK SPASMOLITIK 

(pastisitas(pastisitas(pinal cord in)ury# *+#(pinal cord in)ury# *+#

sklerosis# strokesklerosis# stroke

,uscle spasm,uscle spasmTendon in)ury# in'ammationTendon in)ury# in'ammation

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SPASMOLITIK SPASMOLITIK 

(pastisitas(pastisitasia.epamia.epam

aclo"enaclo"en

antroleneantrolene

Ti.anidineTi.anidine

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DIAZEPAMDIAZEPAM

en.odiasepineen.odiasepine

0AA 0AA  A  A 

1ndikasi semua !entuk1ndikasi semua !entuk

ke)ang otot tu!uhke)ang otot tu!uh

osis 4 mg/hr mg/hrosis 4 mg/hr mg/hr6( sedasi6( sedasi

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BACLOFENBACLOFEN

 Agonis 0AA  Agonis 0AA // (pasmolitik akti" (pasmolitik akti" 

,engurnagi nyeri dengan,engurnagi nyeri denganmengham!at rilis su!stansi +mengham!at rilis su!stansi +

6"ekti7tas sama dg dia.epam# e"ek6"ekti7tas sama dg dia.epam# e"ek

sedasi kurangsedasi kurang

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BACLOFENBACLOFEN

+O# a!sor!si cepat# T 8 3 sd 4 )am+O# a!sor!si cepat# T 8 3 sd 4 )am

9+6# 1ntratekal:9+6# 1ntratekal:

osis 2& ;5 mgosis 2& ;5 mg <ati-hati pada p& epilepsi<ati-hati pada p& epilepsi

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TIZANIDINETIZANIDINE

0olongan clonidin0olongan clonidin Agonis adrenoceptor- Agonis adrenoceptor-==22 ,eningkatkan ham!atan prasinaps dan,eningkatkan ham!atan prasinaps dan

pascasinaps pada cordapascasinaps pada corda ,engham!at transmisi nosisepti" pada,engham!at transmisi nosisepti" pada

cornu dorsalis medula spinaliscornu dorsalis medula spinalis 67kasi se!anding dengan dia.epam#67kasi se!anding dengan dia.epam#

!aclo"en dan dantrolen!aclo"en dan dantrolen 6( kantuk# hipotensi# mulut kering dan6( kantuk# hipotensi# mulut kering dan

asteniaastenia

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DANTROLENEDANTROLENE

eriat hydantoineriat hydantoin

1ntracellular calcium release1ntracellular calcium release

+O hanya ;/3 dia!sor!si+O hanya ;/3 dia!sor!si

Waktu paruh > )amWaktu paruh > )am

osis 25 mg/hr s!g dosis tunggalosis 25 mg/hr s!g dosis tunggal

6( kelemahan otot menyeluruh# sedasi#6( kelemahan otot menyeluruh# sedasi#

hepatitishepatitis Hipertermia maligna – IV 1mg/kg sd 10 Hipertermia maligna – IV 1mg/kg sd 10

mg/kgmg/kg

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SPASMOLITIK SPASMOLITIK 

,uscle spasm,uscle spasm+rimary treatment+rimary treatment

*entrally acting skeletal*entrally acting skeletal

muscle rela&antmuscle rela&ant

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MUSCLE SPASMMUSCLE SPASM

*arisoprodol mepro!amate*arisoprodol mepro!amate9!usu:9!usu:

*hlorphenesin kehamilan #*hlorphenesin kehamilan #!usu# gg lier# kurang > minggu!usu# gg lier# kurang > minggu

*hlor.o&a.one *hlor.o&a.one

agranulositosis# hepatotoksisagranulositosis# hepatotoksis*yclo!en.aprine - tricyclic*yclo!en.aprine - tricyclic

antidepressantantidepressant

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MUSCLE SPASMMUSCLE SPASM

,ata&alone anemia,ata&alone anemiahemolitik# hepatotoksikhemolitik# hepatotoksik

,ethoca!amol p& tetanus,ethoca!amol p& tetanusOrphenadrine antihistamineOrphenadrine antihistamine

anticholinergic e?ect anticholinergic e?ect