Module Neuro 1 Flashcards
baclofen (Lioresal) class
centrally acting muscle relaxant
baclofen (Lioresal) expected pharmacologic action
enhance inhibitory effects of GABA on receptors in the spinal cord, results in suppression of hyperactive reflexes
baclofen (Lioresal) adverse drug reactions
drowsiness, dizziness, weakness, fatigue
nausea, vomiting, constipation, urinary retention rare but possible
baclofen (Lioresal) nursing considerations
take oral doses with food to decrease gastric irritation
encourage fluids and dietary fiber to avoid constipation
centrally acting muscle relaxants - name prototype and others
baclofen (Lioresal)
carisoprodol (Soma)
chlorzoxazone (Parafon Forte)
cyclobenzaprine (Flexeril)
baclofen (Lioresal) contraindications
known hypersensitivity
use of MAOI antidepressants
centrally acting muscle relaxant interactions
avoid alcohol or other CNS depressants
serotonin syndrome can occur if cyclobanzaprine is given to patient on SSRIs, SSNRIs, or tricyclic antidepressants
baclofen (Lioresal) therapeutic use
spinal cord injury
multiple sclerosis
cerebral palsy
peripherally acting muscle relaxants prototype
dantrolene (Dantrium)
dantrolene (Dantrium) class
peripherally acting muscle relaxant
dantrolene (Dantrium) therapeutic use
prevent muscle spasms in CVA, stroke, spinal cord injury, MS, CP
prevent malignant hyperthermia
dantrolene (Dantrium) adverse drug reactions
weakness
drowsiness
dizziness
diarrhea
liver toxicity
dantrolene (Dantrium) nursing considerations
assess muscle strength during treatment
monitor for CNS effects
monitor for diarrhea
monitor liver function
dantrolene (Dantrium) contraindications
liver disease
dantrolene (Dantrium) precautions
cardiac disease
pulmonary disease
neuromuscular disorders
age over 35 years - increased risk for liver damage
dantrolene (Dantrium) interactions
age over 35 and use of estrogen can lead to liver toxicity
avoid use with alcohol or CNS depressants
can cause cardiac dysrhythmias if taken with calcium channel blockers
baclofen (Lioresal) precautions
patients with:
severe mental illness
seizure disorders
stroke
older adults and children under 2 years
AEDs
anti-epileptic drugs
what are hydantoins?
help control tonic-clonic seizures and partial seizures
hydantoins - name prototype and others
phenytoin (Dilantin)
fosphenytoin (Cerebyx)
expected pharmacologic action of hydantoins
decrease neuronal activity by inhibiting influx of sodium through sodium channels
hydantoins - adverse drug reactions
drowsiness
CNS depression
gingival hyperplasia - abnormal tissue growth around gums
skin rash
abrupt discontinuation can lead to recurrence of seizures
hydantoins - nursing actions
monitor for drowsiness and CNS effects
observe gums for hyperplasia
monitor for rashes
phenytoin should be given with meals to prevent GI distress
what precautions should be taken when administering phenytoin IV?
no more than 50 mg per minute, no more than 25 mg per minute for older adults
injecting drug too quickly can cause cardiac collapse
monitor vital signs to identify dysrhythmias or hypotension