CNS Depressants and Muscle Relaxants Flashcards
Baclofen
Chemical Classification
GABA chlorophenyl derivative
Baclofen
Mechanism of Action
Inhibits synaptic responses in CNS by stimulating GABAb receptor subtype, which decreases neurotransmitter function; decreases frequency, severity of muscles spasms
Baclofen
Uses
Spasticity with spinal cord injury, multiple sclerosis
Baclofen
Contraindications
Hypersensitivity
Baclofen
Side Effects
CNS: Dizziness, Weakness, Fatigue, Drowsiness, headache, Disorientation, insomnia, paresthesias, tremors; SEIZURES, LIFE-THREATENING CNS DEPRESSION, COMA; CNS INFECTION (IT)
CV: hypotension, chest pain, palpitations, edema, CARDIOVASCULAR COLLAPSE (IT)
EENT: nasal congestion, blurred vision, mydriasis, tinnitus
GI: Nausea, constipation, Vomiting, increased AST, alk phos, abdominal pain, dry mouth, anorexia
GU: urinary frequency, hematuria
INTEG: rash, pruritus
RESP: dyspnea; respiratory failure (IT)
Baclofen
Nursing Considerations
ASSESS:
- MULTIPLE SCLEROSIS: spasms, spasticity, ataxia; improvement should occur with product BP, weight, blood glucose, hepatic function periodically
- SEIZURES: for increased seizure activity with seizure disorders; product decreases seizure threshold; EEG in epileptic patients
- I&O ratio; check for urinary frequency
- Allergic reactions: rash, fever, respiratory distress
- Severe weakness, numbness in extremities
- Tolerance: increased need for medication, more frequent requests for medication, increased pain
- WITHDRAWAL SYMPTOMS: CNS depression, dizziness, drowsiness, psychiatric symptoms
- INTRATHECAL: have emergency equipment nearby; assess test dose and titration; if no response, check pump, catheter for proper function
PERFORM/PROVIDE:
-Assistance with ambulation if dizziness, drowsiness occurs
Baclofen
Overdose Treatment
Induce emesis of conscious patient, activated charcoal, dialysis, physostigmine to reduce life-threatening CNS side effects
Cyclobenzaprine
Functional Classification
Skeletal muscle relaxant, central acting
Cyclobenzaprine
Chemical Classification
Tricyclic Amine Salt
Cyclobenzaprine
Mechanism of Action
Reduces tonic muscle activity at the brain stem; may be related to antidepressant effects
Cyclobenzaprine
Uses
Adjunct for relief of muscle spasm and pain in musculoskeletal conditions
Cyclobenzaprine
Contraindications
Children <12yr, acute recovery phase of MI, dysrhythmias, heart block, CHF, hypersensitivity, intermittent porphyria, thyroid disease, QT prolongation
Cyclobenzaprine
Side Effects
CNS: Dizziness, Weakness, Drowsiness, headache, tremor, depression, insomnia, confusion, paresthesia, nervousness
CV: postural hypotension, tachycardia, DYSRHYTHMIAS
EENT: diplopia, temporary loss of vision
GI: Nausea, vomiting, hiccups, dry mouth, constipation, hepatitis
GU: urinary retention, frequency, change in libido
INTEG: rash, pruritus, fever, facial flushing, sweating
Cyclobenzaprine
Nursing Considerations
ASSESS:
- PAIN: location, duration, mobility, stiffness at baseline, periodically
- ALLERGIC REACTIONS: rash, fever, respiratory distress
- severe weakness, numbness in extremities
PERFORM/PROVIDE:
-Assistance with ambulation if dizziness, drowsiness occur, especially for geriatric patients
Cyclobenzaprine
Overdose Treatment
Administer activated charcoal; use anticonvulsants if indicated; monitor cardiac function