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Clinical Management of Spasticity and Contractures in Multiple Sclerosis
Published in Anand D. Pandyan, Hermie J. Hermens, Bernard A. Conway, Neurological Rehabilitation, 2018
Because of its muscle weakness-inducing properties, dantrolene may be more suitable for patients who are not mobile. Other commonly reported side effects include drowsiness and gastrointestinal upset, nausea, and diarrhoea. Severe and irreversible liver damage can occur with dantrolene therapy and routine monitoring of liver function tests is mandatory (Durham et al. 1984).
Paediatric anaesthesia
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Nigel Pereira, Liz Storey, Rob E John
Considering anaesthesia and malignant hyperthermia.This condition has characteristic clinical signs.It is safe to use suxamethonium in this case.Suxamethonium would likely induce a sustained rise in myoplasmic calcium.A caffeine halothane contracture test can be done at any age.Postpone the operation until the diagnosis is established.A surgeon with a family history of this condition should not work in an operating room.Local anaesthetics are unsafe in this case.Intravenous calcium is contraindicated in resuscitating this patient.Dantrolene 2.5 mg/kg should be given immediately and repeated as needed.Insulin and dextrose may be needed to treat hypokalaemia.
Oral Medication
Published in Valerie L. Stevenson, Louise Jarrett, Spasticity Management, 2016
Dantrolene is a novel drug for spasticity management, as it is the only available agent that works outside the CNS, with a direct action on skeletal muscle. It is therefore a useful adjunct to a centrally acting agent for combination therapy.
Fatal serotonin syndrome: a systematic review of 56 cases in the literature
Published in Clinical Toxicology, 2021
Sanjay Prakash, Chaturbhuj Rathore, Kaushik Rana, Anurag Prakash
Details of treatment were available for 37 (66%) cases. Most of the patients received supportive therapies. Nine patients (16%) received cyproheptadine, with the doses described for six patients. These included 4 mg every 4 h [26], 8 mg followed by 4 mg every 8 h [27], 8 mg every 6 h for 4 d [32], a total dose of 24 mg [33], 12 mg over 5 h [44], and 12 mg once followed by 2 mg every 2 h for 24 h [51]. Benzodiazepines were given in seven patients (midazolam – five patients and diazepam – two patients). The doses of midazolam was described for three patients, a total dose of 8 mg in two patients [11, 26], and 5 mg every hour in one patient. The dose of diazepam was mentioned in one patient (a total dose of 10 mg) [14]. Seven (13%) patients received dantrolene. Fentanyl was administered to two patients.
Continuum of care and longitudinal recovery in a 17-year-old athlete with second impact syndrome
Published in Brain Injury, 2023
Nabela Enam, Hansen Deng, Nicholas S. Race, Dewan S. Majid, David O. Okonkwo, Kevin M. Franzese
As the paroxysmal sympathetic hyperactivity of the patient improved, propranolol and clonidine were tapered off. He was continued on gabapentin and started on valproic acid for impulsivity and agitation. Dantrolene was initiated to address right-sided spasticity while minimizing sedating side effects often seen with other anti-spasticity medications. Tonicity measure was 3 on the Modified Ashworth Scale and required serial up-titration of dantrolene. Eventually, his tone was deemed functionally beneficial for mobility. He was fitted for a custom hinged ankle-foot-orthosis (AFO) for his right foot drop.
Malignant syndromes: current advances
Published in Expert Opinion on Drug Safety, 2021
Minghua Tao, Jiyuan Li, Xuefeng Wang, Xin Tian
Dantrolene is a RYR antagonist that directly acts on skeletal muscle, and its role is to reduce heat production and relieve muscle rigidity. Its usage and dosage differ among malignant syndromes. The side effects of dantrolene include drowsiness, muscle weakness, pulmonary edema, phlebitis, hepatotoxicity, and seizures, but they are uncommon, and the most serious side effect is hepatotoxicity [86].