Muscle Relaxants Flashcards
NSAIDS used for muscle spasms
- Aspirin, naproxen, ibuprofen
- Can be used in conjunction with muscle relaxants
different types of muscle spasticity management
- direct acting muscle relaxers
- physical therapy
- centrally acting muscle relaxers
Skeletal muscle relaxants contraindicated in…
- clients with severe liver, renal or heart disease (medications are metabolized in the liver and excreted by the kidneys)
- do not take with other CNS depressants (opioids, alcohol, sedatives, hypnotics, tricyclic anti-depressants, barbiturates, benzodiazepines)
Adverse Effects Skeletal Muscle Relaxants:
Dizziness, drowsiness Hypotension Constipation, urinary retention Muscle weakness Dry mouth GI upset Photosensitivity (pupil dilation, SNS) Liver toxicity
Nursing Implications Muscle Relaxants
- Evaluate for therapeutic effects of medication
- Monitor for anticholinergic effects (dry mouth, urinary retention)
- Report tachycardia, excessive drowsiness
- Monitor for orthostatic hypotension
- Avoid other CNS depressant drugs (including alcohol)
- Obtain medical history and vital signs
- Monitor for CNS adverse effects
- Assess risk of injury; provide for client safety
- Assess involved muscles for pain and mobility
- Monitor renal and liver function tests
- Teach client to take with food to decrease GI upset
- Instruct client to avoid activities requiring alertness (driving, operating equipment)
Centrally Acting Muscle Relaxants: Cyclobenzaprine (Amrix, Flexeril)
- Contraindicated in patients who have taken monoamine oxidase inhibitors (MAOIs)(break down SNS?) within 14 days of initiation of cyclobenzaprine or in patients with cardiac disorders
- Has anti-cholinergic effects and should be used with caution in clients with urinary retention, angle-closure glaucoma, or increased intraocular pressure
- Used only for short term therapy (2-3 weeks)
Centrally Acting Muscle Relaxants: Baclofen (Lioresal)
- Can be used for spasm and spasticity
- Resembles neurotransmitter GABA
- Can be given intra-thecally
- used for MS
Centrally Acting Muscle Relaxants: Carisoprodol (Soma)
- Produces significant sedation
- Take with food to prevent GI upset
Report rash to HCP
Centrally Acting Muscle Relaxants: Methocarbamol (Robaxin)
- Parenteral form can cause hypotension, bradycardia, anaphylaxis, and seizures if given too rapidly. Parenteral form contraindicated with renal impairment
- Can turn urine brown, green, or black
- Monitor for extravasation which can cause thrombophlebitis and tissue sloughing
- Inform HCP if blurred vision, nasal congestion, urticaria or rash
Centrally Acting Muscle Relaxants: Orphenadrine (Norflex)
- Has anti-cholinergic effects
- Use with caution in patients with closed angle glaucoma, urinary retention, or increased intra-ocular pressure
Centrally Acting Muscle Relaxants: Tizanidine (Zanaflex) and Metaxalone (Skelaxin)
- Can cause hepatotoxicity
Centrally Acting Muscle Relaxants: Chlorzoxazone (Paraflex, Parafon Forte, Remular-S)
- Monitor for hypersensitivity (pruritis, redness, urticaria, angioedema)
- May cause malaise
- May cause urine to turn oragne or red
- Can cause hepatotoxicity
List of Centrally Acting Muscle Relaxants
- Cyclobenzaprine (Amrix, Flexeril)
- Baclofen (Lioresal)
- Carisoprodol (Soma)
- Methocarbamol (Robaxin)
- Orphenadrine (Norflex)
- Tizanidine (Zanaflex)
- Metaxalone (Skelaxin)
- Chlorzoxazone (Paraflex, Parafon Forte, Remular-S)
CBCMOTMC
MC CC TOMB
Benzodiazepines: example and function
- Diazepam (Valium)
- Adjunct to relieve skeletal muscle spasm associated with cerebral palsy, paraplegia and tetanus
- Used only if other medications fail to produce adequate muscle relaxation
- Scheduled IV drug and can cause dependence.
Direct-Acting Skeletal Muscle Relaxants: characteristics
- Also called peripherally acting muscle relaxants
- Act directly on skeletal muscle to relieve spasticity
- Also called anti-spasticity agents
- Drugs of choice for muscle spasticity
- Interfere with calcium release from muscle tubules and thus prevent the fibers from contracting
