Zanaflex for pediatrics?

[FenderBender]

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What is the consensus on using Zanaflex or other muscle relaxers on kids less than 12 years old? I could not find any information on Lexicomp, UpToDate, or Epocrates. I also searched on Google and couldn't find anything solid.

 

[farmadiazepine]

there is info on pediatric lexi on baclofen, dantrolene, diazepam, chlorzoxazone.

 

[type b pharmD]

the real question to ask is how much of tizanidine's action is mediated by alpha 2 agonism and how much is mediated by imidazoline receptor agonism. This one is still stumping me. 😛 .. ok ok jk

Tizanidine in kids .. what could go wrong?

On the other hand like farma said, baclofen and friends bring better data.

 

[cycloketocaine]

the real question to ask is how much of tizanidine's action is mediated by alpha 2 agonism and how much is mediated by imidazoline receptor agonism. This one is still stumping me.

Tizanidine in kids .. what could go wrong?

On the other hand like farma said, baclofen and friends bring better data.

We use baclofen or cyclobenzaprine. Ive used both in young toddlers.

 

[cycloketocaine]

What is the consensus on using Zanaflex or other muscle relaxers on kids less than 12 years old? I could not find any information on Lexicomp, UpToDate, or Epocrates. I also searched on Google and couldn't find anything solid.

And for the love of a monkey, never EVER use epocrates for pediatrics.

 

[type b pharmD]

We use baclofen or cyclobenzaprine. Ive used both in young toddlers.

bah cyclobenzaprine is such a 'dirty' drug 🙁

i admit i have a osmewhat inordinate fascination with the imidazolines but , baclofen is really an up and comer in the sense that I believe we'll see new drugs in the next decade based on it, since it is getting preliminary data for about 100 diff conditions and the safety data is there.

as an fyi, clonidine has some basic safety as off label ADHD treatment, and baclofen has shown promise in autism, so these are drugs that are clearly beneficial in some peds, and based on what we know about the actions, very safe.

Here is a morsel.

http://www.ncbi.nlm.nih.gov/pubmed/17156708

edit: i mention clonidine because it has a lot more data and studies than tizanidine, and appears to be arguably very similar in action to its sibling, but again the question of relative imidazoline vs alpha selectivity gets in the way

 

[cycloketocaine]

bah cyclobenzaprine is such a 'dirty' drug 🙁

i admit i have a osmewhat inordinate fascination with the imidazolines but , baclofen is really an up and comer in the sense that I believe we'll see new drugs in the next decade based on it, since it is getting preliminary data for about 100 diff conditions and the safety data is there.

as an fyi, clonidine has some basic safety as off label ADHD treatment, and baclofen has shown promise in autism, so these are drugs that are clearly beneficial in some peds, and based on what we know about the actions, very safe.

Here is a morsel.

http://www.ncbi.nlm.nih.gov/pubmed/17156708

Lulz, you know I'm a pediatric pharmacist, right? We use clonidine all the time, mostly for a withdrawal adjunct.

Everything in pediatrics is gray area.

 

[cycloketocaine]

bah cyclobenzaprine is such a 'dirty' drug 🙁

i admit i have a osmewhat inordinate fascination with the imidazolines but , baclofen is really an up and comer in the sense that I believe we'll see new drugs in the next decade based on it, since it is getting preliminary data for about 100 diff conditions and the safety data is there.

as an fyi, clonidine has some basic safety as off label ADHD treatment, and baclofen has shown promise in autism, so these are drugs that are clearly beneficial in some peds, and based on what we know about the actions, very safe.

Here is a morsel.

http://www.ncbi.nlm.nih.gov/pubmed/17156708

edit: i mention clonidine because it has a lot more data and studies than tizanidine, and appears to be arguably very similar in action to its sibling, but again the question of relative imidazoline vs alpha selectivity gets in the way

I would have a helluva time convincing my attendings to use clonidine over something like baclofen or cyclo. you have to think about S/E profiles too...

 

[type b pharmD]

Yes, although it may have slipped my mind there for a second , I knew you spoke with the weight of authority from experience.

I'm sure cyclo has a good role , and I was not arguing against its use, I personally just dont like subjecting people to tricyclic side effects when there are other options , but i'm not a peds pharmacist.

The info about the clonidine was meant for the OP .. as i'm sure you already knew the bottom line. sometimes the reply and quote buttons get the better of me , and it becoems unclear to whom I'm speaking.

Keep up the good work, im glad you are so informed!

 

[type b pharmD]

I would have a helluva time convincing my attendings to use clonidine over something like baclofen or cyclo. you have to think about S/E profiles too...

Yes. I would agree. Clonidine not great as a SMR in anyone really. I was just saying , if someone wants to know if tizanidine is safe , just look at clonidine.

 

[cycloketocaine]

Yes, although it may have slipped my mind there for a second , I knew you spoke with the weight of authority from experience.

I'm sure cyclo has a good role , and I was not arguing against its use, I personally just dont like subjecting people to tricyclic side effects when there are other options , but i'm not a peds pharmacist.

The info about the clonidine was meant for the OP .. as i'm sure you already knew the bottom line. sometimes the reply and quote buttons get the better of me , and it becoems unclear to whom I'm speaking.

Keep up the good work, im glad you are so informed!

Dang, getting kind of snappy are we? 😉

 

[type b pharmD]

Dang, getting kind of snappy are we? 😉

🙁 negative. I was being sincere. Everyone knows you know your stuff for peds.

,definitely not intended for it to come out that way.

I am actually glad when someone is informed about their **** . Cause a lot of people out there arent and it sucks for patients and healthcare staff alike.

 

[cycloketocaine]

🙁 negative. I was being sincere. Everyone knows you know your stuff for peds.

,definitely not intended for it to come out that way.

I am actually glad when someone is informed about their **** . Cause a lot of people out there arent and it sucks for patients and healthcare staff alike.

It's all good, I'm just very passionate about my work kids.

Strong work! What are you going to be when you grow up?

 

[type b pharmD]

It's all good, I'm just very passionate about my work kids.

Strong work! What are you going to be when you grow up?

In an ideal world? doing consults all day for psych/neuro , in the real world, small town retail or independent retail. Low gpa and family/financial concerns preclude residency, but im satisfied that I'll be able to help enough people offering clinical advice to retail patients.

But just cause im not doing a residency wont stop me from continuing to learn and read up on this stuff!!