Pharmacologic Profile

General Use

Two major uses are spasticity associated with spinal cord diseases or lesions (baclofen and dantrolene) or adjunctive therapy in the symptomatic relief of acute painful musculoskeletal conditions (carisoprodol, chlorzoxazone, cyclobenzaprine, diazepam, and methocarbamol). IV dantrolene is also used to treat and prevent malignant hyperthermia.

General Action and Information

Act either centrally (baclofen, carisoprodol, cyclobenzaprine, metaxolone, and methocarbamol) or directly (dantrolene).

Contraindications

Baclofen and oral dantrolene should not be used in patients in whom spasticity is used to maintain posture and balance.

Precautions

Safety in pregnancy and lactation not established. Use cautiously in patients with a history of previous liver disease.

Interactions

Additive CNS depression with other CNS depressants, including alcohol, antihistamines, antidepressants, opioid analgesics, and sedative/hypnotics.

Nursing Implications

Assessment

• Assess patient for pain, muscle stiffness, and range of motion before and periodically throughout therapy.

Potential Nursing Diagnoses

• Acute pain (Indications)
• Impaired physical mobility (Indications)
• Risk for injury (Side Effects)

Implementation

• Provide safety measures as indicated. Supervise ambulation and transfer of patients.

Patient/Family Teaching

• Encourage patient to comply with additional therapies prescribed for muscle spasm (rest, physical therapy, heat).
• Medication may cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to drug is known.
• Advise patient to avoid concurrent use of alcohol or other CNS depressants with these medications.

Evaluation/Desired Outcomes

• Decreased musculoskeletal pain
• Decreased muscle spasticity
• Increased range of motion
• Prevention or decrease in temperature and skeletal rigidity in malignant hyperthermia.