Re: [問題] Tizanidine

[greatfish (內科OHCA請準備!)]

※ 引述《zee7912 (美好的未來)》之銘言：
: 大家好
: 想請問各位學姐Tizanidine這顆藥
: 我有查過這顆藥是減少神經興奮性胺基酸分泌，可避免肌肉過度緊張，主要作用在脊髓
: 為一種中樞作用的骨骼肌鬆弛劑。
: 我的p't有打嗝的困擾，且雙腳有不自主的神經抽動(腳指頭有時會翹一下)
一直打嗝! 超有趣的
今天morning meeting 才剛好有講到
大概分幾個方向去思考
cancer!
腹壓不平衡!
神經方面!
精神方面!

看看患者是吃飽才打嗝
還是沒吃也一直打嗝
是否有吃產氣食品
會不會很神經質!

如果有plain abd x-ray or CXR看一下
是否有橫膈疝氣
BOWEL GAS OR STOMACH GAS 是否多到脹得不像話
BOWEL GAS 分布是否均勻 有沒有像被東西推開的感覺 (Mass?)

讀過篇 paper
很多不自主打嗝有些是精神疾病
患者如果排除掉生理的問題 通常只要讓患者忙一點
就可以有效改善?(轉移注意焦點)

神經方面 我就比較不懂了

: 想請問這顆藥，是可以治療打嗝還是他腳的不自主神經抽動
: 還是兩個都可以有幫助?
: 謝謝~
Tizanidine
我查了一下 並沒有治療打嗝神奇的功能
再看看有沒有藥學高手要出手相救
就決定是你了 f12508 XDDD 六個月後跟另一位我們台北見面喔

Tizanidine (brandnames Zanaflex, Sirdalud) is a drug that is used as a muscle
relaxant. It is a centrally acting α-2 adrenergic agonist. It is used to
treat the spasms, cramping, and tightness of muscles caused by medical
problems such as multiple sclerosis, spastic diplegia, back pain, or certain
other injuries to the spine or central nervous system. It is also prescribed
off-label for migraine headaches, as a sleep aid, and as an anticonvulsant.
It is also prescribed for some symptoms of fibromyalgia[1].

Tizanidine may cause hypotension, so caution is advised when it is used in
patients who have a history of orthostatic hypotension. Use caution with this
drug as it can be very strong even at the 2 mg dose. Also use caution when
switching from gel cap to tablet form and vice versa.

[edit] Side effects
Tizanidine use occasionally causes drug induced liver injury. In controlled
clinical studies, approximately 5% of patients treated with Zanaflex had
elevations of liver function tests (ALT, AST) to greater than 3 times the
upper limit of normal (or 2 times if baseline levels were elevated).[citation
needed]

Tizanidine use has been associated with hallucinations. Visual hallucinations
and delusions have been reported in 5 of 170 patients (3%) in two North
American controlled clinical studies.[citation needed]

If therapy needs to be discontinued, especially in patients who have been
receiving high doses for long periods, the dose should be decreased slowly to
minimize the risk of withdrawal and rebound hypertension, tachycardia, and
hypertonia.


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◆ From: 122.120.4.228
※ 編輯: greatfish       來自: 122.120.4.228        (11/27 17:56)
推 piousfaith:CVA後的病人的確是會不停打嗝...(by NSP)
推 phbkj:CVA後的病人會一直打嗝+1
→ phbkj:開顱術後的病人或是做V-P shunt的病人也會打嗝
推 tonys1126:敢問樓上兩位大大 原理是什麼咧:D
→ greatfish:pio大 神經方面 phbkj腹壓
推 phbkj:顱內病變者會影響腦幹及迷走神經經異常放電，導致橫隔膜肌肉
→ phbkj:收縮，刺激胃黏膜，膈肌痙攣而出現打嗝情形。