A hospital staff was charged for murdering six elderly hospital patients by giving those overdoses of two muscle relaxants in 1996 and 1997. The suspect used muscle relaxants Pavulon and succinylcholine chloride, commonly known as SUCC -- to shut down the respiratory systems of the patients, essentially suffocating them.

In another incident, Raplon, another popular muscle relaxant was voluntarily withdrawn by its manufacturer from the market after five reported deaths related to its use. Doctors often use Raplon when inserting a breathing tube in patients, and it is a good choice because of the drug's effectiveness wore off quickly. Despite its benefits, Raplon was pulled from the market because it tends to cause airway spasms that interfere with normal breathing.

The US Food and Drug Administration (FDA) were already aware of this side effect, especially since most muscle relaxants can cause similar problems. Called bronchospasms, the breathing problem can range from mild to severe and is noted to occur in 3.2 percent of all patients who use Raplon.

Raplon is the twelfth drug removed from the market since 1997. This is causing a bit of a stir, with many people questioning the FDA's rapid approval of drugs. The FDA has been under pressure from Congress to speed up the approval times of new drugs.

But law makers and consumers would not want quality and safety to be sacrificed for a fast approval time. Though the demands of new drugs are indeed high, the FDA should always keep a keen eye on the effects and effectiveness of these drugs. Once the drug is approved and sold in the market, recall would take more effort especially when some lives have already been wasted.

Muscle Relaxants

Skeletal muscle relaxants are a heterogeneous group of medications commonly used to treat two different types of underlying conditions namely spasticity from upper motor neuron syndromes and muscular pain or spasms from peripheral musculoskeletal conditions.

Although they have by convention been classified into one group, the FDA has approved only a few medications in this class for treatment of

spasticity; the remainder are approved for treatment of musculoskeletal conditions.

Data from the Third National Health and Nutrition Examination (NHANES III) survey (1988-1994) estimated that 1% of American adults are taking muscle relaxants, often on a chronic basis.

Spasticity, although difficult to define precisely, is a clinical condition that has been described as a motor disorder characterized by velocity dependent increase in tonic stretch reflexes or muscle tone. This also goes with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex, as one component of the upper motor neuron syndrome.

Some of the more common conditions associated with spasticity and requiring treatment include multiple sclerosis, spinal cord injury, traumatic brain injury, cerebral palsy, and post-stroke syndrome.

Common musculoskeletal conditions causing tenderness and muscle spasms include fibromyalgia, tension headaches, myofascial pain syndrome, and mechanical low back or neck pain. If muscle spasm is present in these conditions, it is related to local factors involving

the affected muscle groups.

This type of drug is said to relax certain muscles in the body and relieve the stiffness, pain and discomfort caused by strains, sprains or other injury to your muscles. However, these medicines do not take the place of rest, exercise or physical therapy, or other treatment that your doctor may recommend for your medical problem.

The Aftermath

Since the relaxants act in the central nervous system, their actions may produce some side effects. In the U.S., dispensing of muscle relaxants without doctor's prescription is strictly prohibited but in other countries, some muscle relaxants can be sold without prescription.

With the many reported abuse and deaths using muscle relaxants, patients have become cautious. Likewise concerned government agencies continue to monitor the dispensing of these drugs to avoid further loss on human lives.

Controversies surrounding muscle relaxants have resulted in some resistance to their use in patient care. Studies have been published which suggest a potential role for muscle relaxants in clinical practice; however, there is a lack of good quality research on the clinical application of these drugs.

It cannot be denied that muscle relaxants are effective in the management of a number of ailments but the adverse effects require that they be used with caution.