Guideline sources The following summarized guidelines for the management of muscle cramps are prepared by our editorial team based on guidelines from the American Academy of Neurology (AAN 2010). 1 Guidelines 1. Medical management Quinine derivatives: avoid quinine derivatives in the management of muscle cramps because of the potential of toxicity; consider their use in select patients once potential side effects are taken into account. D First-line agents: consider vitamin B complex, CCBs such as diltiazem, or naftidrofuryl as first-line agents in the management of muscle cramps. C Clinical findings Patient demographics Symptoms Elderly age Sharp pain Past medical history Medication history Diabetes mellitus Diuretics Hypothyroidism https://web.pathway.md/diseases/recgXe0uhDlhINMBW 1/2 6/30/23, 1:06 AM Muscle cramps Pathway Integument exam Past obstetric history Dehydration Pregnancy Lab findings serum calcium serum magnesium serum potassium References 1. Hans D Katzberg, Ahmir H Khan, Yuen T So. Assessment: symptomatic treatment for muscle cramps (an evidence-based review): report of the therapeutics and technology assessment subcommittee of the American academy of neurology. Neurology. 2010 Feb 23;74 8 691 6. Open 2. Timothy M Miller, Robert B Layzer. Muscle cramps. Muscle Nerve. 2005 Oct;32 4 431 42. Open 3. Michael Behringer, Markus Moser, Molly McCourt et al. A promising approach to effectively reduce cramp susceptibility in human muscles: a randomized, controlled clinical trial. PLoS One. 2014 Apr 11;9 4):e94910. Open 4. Gavin Young. Leg cramps. BMJ Clin Evid. 2009 Mar 26;2009 1113. Open https://web.pathway.md/diseases/recgXe0uhDlhINMBW 2/2