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SKELETAL MUSCLE RELAXANTS (NAME OF DRUGS (Baclofen, Carisoprodol,…
SKELETAL MUSCLE RELAXANTS
NAME OF DRUGS
Baclofen
Carisoprodol
Chlorzoxazone
Methocarbamol
Orphenadrine
Tizanidine
Dantrolene
INDICATIONS
Muscle spasms
Spinal injuries
Muscle spacity
Tetanus (children)
Cerebral palsy (children)
NURSING CONSIDERATIONS
Provide additional spasm and pain relief like rest periods, heat application, NSAIDs as ordered, and position to augment
Discontinue drug at any sign of liver and renal dysfunction to prevent severe toxicity.
Monitor respiratory status to evaluate adverse effects and arrange for appropriate dose adjustment or discontinuation of drug
Provide comfort measures to help patient tolerate drug effects
Educate client on drug therapy to promote understanding and compliance
ADVERSE EFFECTS
CNS: depression, drowsiness, fatigue, weakness, confusion, headache, insomnia.
CV: hypotension, arrhythmias
GI: nausea, dry mouth, anorexia, constipation
GU: urinary frequency, enuresis, urinary urgency
Tizanidine has been associated with liver toxicity and hypotension in some patients.
Baclofen is tapered over 1-2 weeks to prevent development of psychoses and hallucinations.
CONTRA-INDICATIONS
Cardiac dysfunction. Muscle function may be depressed.
Condition marked by muscle weakness. Can be exacerbated by drugs
Hepatic, renal dysfunction. Interfere with drug metabolism and excretion.
Baclofen is not indicated for treatment of spasticity that contributes to locomotion, upright function, or increased function. Blocking this spasticity results in loss of these functions
History of epilepsy. CNS depression and imbalance caused by drugs may exacerbate seizure disorder
ROUTE OF ADMINISTRATION
Orally
Intrathecally (spinal)
INTRAVENOUSLY
MECHANISM OF ACTION
Muscle relaxants work by causing the muscles to become less tense or stiff, which in turn reduces pain and discomfort. They do this in different ways. Baclofen, diazepam, methocarbamol and tizanidine act on the central nervous system (brain and spinal cord). Dantrolene works directly on the muscle
STORAGE
Must use the contents of the vial within 6 hours after reconstitution. Store reconstituted suspensions at controlled room temperature (68°F to 77°F or 20°C to 25°C). Dantrolene is given by direct injection and is incompatible with D5W or NS.