Overview of Systemic Pharmacotherapeutics of the Muscular System

Drugs that affect skeletal muscle function fall into several therapeutic categories. Some are used during surgical procedures to produce paralysis (neuromuscular blocking agents); others reduce spasticity (skeletal muscle relaxants) associated with various neurologic and musculoskeletal conditions. In addition, several therapeutic agents influence metabolic and other processes in skeletal muscle, including the nutrients required for normal muscle function used to prevent or mitigate degenerative muscular conditions. For example, selenium and vitamin E are used to prevent or treat muscular dystrophies such as white muscle disease (see Nutritional Myodegeneration). The steroidal, nonsteroidal, and various other anti-inflammatory agents (eg, dimethyl sulfoxide) are also commonly used to treat acute and chronic inflammatory conditions involving skeletal muscle. Anabolic steroids promote muscle growth and development and are administered in selected cases in which serious muscle deterioration has developed as a complication of a primary disease syndrome.

The clinical pharmacology of the neuromuscular blocking agents, skeletal muscle relaxants, and anabolic steroids are discussed below. (For anti-inflammatory agents, see Anti-Inflammatory Agents.)