Muscle Relaxants

Question 1

non-pharmacological muscle relaxants

Answer 1

• rest
• ice application on acute injuries to decrease inflammation
• compression & elevation to decrease swelling
• heat applications to help alleviate pain
• physical therapy

Question 2

Centrally acting skeletal muscle relaxants

Answer 2

Actions: depresses CNS

Uses:

• relief of discomfort associated with acute, painful musculoskeletal conditions
• works in the CNS to interfere with the reflexes causing the muscle spasm
• decreases muscle spasm or spasticity

Ex:
-baclofen (Lioresal): used for treating muscle spasticity associated with neuromuscular diseases such as multiple sclerosis, muscle rigidity & spinal cord injuries

• methocarbamol (Robaxin): also used to alleviate signs & symptoms of tetanus among children
• cyclobenzaprine (Flexeril)
• diazepam (Valium): used for patients experiencing severe muscle spasms & pain precipitated by anxiety

Nursing indications (Caution):

• since it affects the upper levels of the CNS, it can cause depression
• use with caution for patients who are drowsy
• patient is at fall risk

Question 3

Direct-acting skeletal muscle relaxants

Answer 3

Uses:
-enters the muscle to prevent muscle contractions

Ex:

• botulinum toxin type A
• butulinum toxin type B
• dantrolene (Dantrium)
• Incobotulinumtoxin A (Xeomin)

Possible side effects:
-Dantrolene: drowsiness, fatigue, weakness, confusion, headache, insomnia & visual disturbances; GI irritation, diarrhea, constipation, & abdominal cramps; urinary frequency, enuresis, dysuria due to crystalline urine

-Botulinum toxins: headache, dizziness, muscle pain & paralysis; erythema & edema @ the injection site

Nursing responsibilities:

• Monitors:
  - response to drug
  - adverse effects
  - liver function