Case study 6

He has spasticity, muscle spasms, contractures of his muscles, and demonstrates scissoring. He is currently on baclofen (Lioresal) and tizanidine (Zanaflex). His mother asks you if cyclobenzaprine (Flexeril) might be a good choice to help Mark with his spasticity and muscle spasms. She is concerned that Mark always appears drowsy and fatigued. She also reports that he seems to always have a dry mouth and be constipated. She says that she heard botox injections help people with spasticity. She wants to know if botox is safe to use and is a possibility for Mark.•    What are some non-pharmacologic therapies that may be useful for Mark?•    What type of medications (class of medications) are Lioresal and Zanaflex? Explain how they work.•    Why do you think this patient may be drowsy and fatigued?•    Why may he have a dry mouth and be constipated?•    Discuss why Mark has the side effects of drowsiness, fatigue, dry mouth, and constipation, in terms of the medications he is on.•    What should you tell Mark’s mother about the use of cyclobenzaprine (Flexeril) for her son?o    Is this a recommended medication for Mark’s condition?o    Be sure to state why/why not.•    How does this medication work and what are some of the side effects? e.•    What can you tell Mark’s mom about the use of botox for muscle relaxation?o    What type of drug is this and how does it work?•    Do you think this is a good option for Mark? Consider side effects and usefulness of this type of drug treatment in light of Mark’s condition.

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