Smooth muscle spasm
One type of antispasmodics is used for smooth muscle relaxation, especially in tubular organs of the gastrointestinal tract. The effect is to prevent spasms of the stomach, intestine or urinary bladder.
Both dicyclomine and hyoscyamine are antispasmodic due to their anticholinergic action. Both of these drugs have general side effects and can worsen gastroesophageal reflux disease.
Mebeverine is a muscolotropic spasmolytic with a strong and selective action on the smooth muscle spasm of the gastrointestinal tract, particularly of the colon. It does not have the acetylecholine side effect commonly seen in an anticholinergic antispasmodic.
Peppermint oil has been traditionally used as an antispasmodic, and a review of studies on the topic found that it “could be efficacious for symptom relief in IBS“ (as an antispasmodic) although more carefully controlled studies are needed. A later study showed it is an effective antispasmodic when test-applied topically to the intestine during endoscopy.
Skeletal muscle spasm
Pharmacotherapy may be used for acute musculoskeletal conditions when physical therapy is unavailable or has not been fully successful. Another class of antispasmodics for such treatment includes cyclobenzaprine, carisoprodol, diazepam, orphenadrine, and tizanidine. Effectiveness has not been clearly shown for metaxalone, methocarbamol, chlorzoxazone, baclofen, or dantrolene. Applicable conditions include acute back or neck pain, or pain after an injury.
Spasm may also be seen in movement disorders featuring spasticity in neurologic conditions such as cerebral palsy, multiple sclerosis, and spinal cord disease. Medications are commonly used for spastic movement disorders, but research has not shown functional benefit for some drugs. Some studies have shown that medications have been effective in decreasing spasticity, but that this has not been accompanied by functional benefits. Medications such as baclofen, tizanidine, and dantrolene have been used.
- “Antispasmodic”. thefreedictionary.com. Retrieved February 1, 2016.
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- Pittler, M.H.; Ernst, E. (1998). “Peppermint oil for irritable bowel syndrome: A critical review and metaanalysis”. The American Journal of Gastroenterology. 93 (7): 1131–5. doi:10.1111/j.1572-0241.1998.00343.x. PMID 9672344.
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- Chou, Roger; Peterson, Kim; Helfand, Mark (2004). “Comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions: A systematic review”. Journal of Pain and Symptom Management. 28 (2): 140–75. doi:10.1016/j.jpainsymman.2004.05.002. PMID 15276195.
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