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Although skeletal muscle relaxants are an important modality for the treatment of acute musculoskeletal pain and spasm, a number of concerns about their use remain unresolved. No one single agent has proved superior to another.7, 47 Clinical trials have yet to be performed to determine whether skeletal muscle relaxants or analgesics are more efficacious for treating paravertebral spasm or whether the best approach would be to use these medications simultaneously to combat both components of the painspasmpain cycle.7 Because it is not yet clear as to which agent is best, it has been suggested that preference be given to the non-benzodiazepines with more evidence to support their efficacy e.g., cyclobenzaprine, carisoprodol, orphenadrine, tizanidine ; .22 Without a clearly superior agent, side-effect profiles become a significant consideration in the selection of medications to be prescribed in individual cases. Cost difference is not a significant factor. All of these agents are available as generic preparations. The abuse potential of skeletal muscle relaxants appears to be poorly recognized in the medical community. Clinicians may feel comfortable prescribing these agents because they are not controlled substances at the federal level, but carisoprodol is thought to carry an important risk for abuse because of its metabolism to meprobamate. A final question to consider is how long these agents should be used. Nearly all clinical trials of skeletal muscle relaxants have involved their short-term use.22 The possible role of these medications in the treatment of chronic back pain is a more complex issue.
Fig 1 illustrates the cumulative permeation of cyclobenzapirne compared to Nitro-Dur 5 cm2 0.1 mg hr ; control over a 24-hour time period. Results from Formula 1 indicate that permeability is significant without an enhancer. For direct comparison with Nitro-Dur, the following table and calculations are based on a total of 24-hours of sampling. The cyclobenzaprin4 cells were sampled for another 24 hours to complete a 48-hour delivery profile. TABLE 2: Slope of the Best-Fit Line for Cumulative Permeation. Formulation Nitro-Dur 1 2 Cumulative Permeation Slope of Best-Fit Line 13.589 g cm2 hr 10.587 g cm2 hr 11.349 g cm2 hr and evista and cyclobenzaprine.
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If you are reading MedicinesTalk, you are presumably reading it because you want to learn more about medicines. But, have you ever wondered how people from multicultural communities whose first language is not English might obtain such information? The `Families get to know their medicines' trial is a new project that hopes to reach families from long-settled multicultural communities. The project will incorporate information about the quality use of medicines into the language lessons given to 10 16 year old students attending Chinese, Greek and Vietnamese after hours ethnic schools in Queensland. The project is based on a concept of `kitchen table discussions', where it is hoped that students will share their newly acquired knowledge with their parents, grandparents and other family members when they discuss around.
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