cyclobenzaprine hydrochloride Nursing Considerations & Management

 Drug Name

Generic Name : cyclobenzaprine hydrochloride

Brand Name: Apo-Cyclobenzaprine (CAN), Flexeril, Novo-Cycloprine (CAN)

Classification: Skeletal muscle relaxant (centrally acting)

Pregnancy Category B

Dosage & Route
Adults
  • 5 mg PO tid, 10 mg PO tid (range 20–40 mg/day in divided doses); do not exceed 60 mg/day; do not use longer than 2 or 3 wk.
Pediatric Patients
  • Safety and efficacy in patients < 15 yr not established.
Therapeutic actions
  • Precise mechanism not known; does not directly relax tense skeletal muscles but appears to act mainly at brain stem levels or in the spinal cord.
Indications
  • Relief of discomfort associated with acute, painful musculoskeletal conditions, as adjunct to rest, physical therapy
  • Unlabeled use: Adjunct in the management of fibrositis syndrome
Adverse effects
  • Antimuscarinic effects, neurological adverse effects, GI disorders, orthostatic hypotension, tachycardia, hypersensitivity reactions. Rarely, cholestatic jaundice and blood disorders. Endocrine effects, sexual dysfunction, changes in blood sugar. Increased appetite with wt gain, sweating.
Contraindications
  • Contraindicated with hypersensitivity to cyclobenzaprine, acute recovery phase of MI, arrhythmias, heart block or conduction disturbances, CHF, hyperthyroidism.
  • Use cautiously with urinary retention, angle-closure glaucoma, increased IOP, lactation, mild hepatic impairment.
Nursing considerations
Assessment
  • History: Hypersensitivity to cyclobenzaprine, acute recovery phase of MI, arrhythmias, CHF, hyperthyroidism, urinary retention, angle-closure glaucoma, increased IOP, lactation
  • Physical: Orientation, affect, ophthalmic examination (tonometry); bowel sounds, normal GI output; prostate palpation, normal voiding pattern; thyroid function tests
Interventions
  • Arrange for analgesics if headache occurs.
Teaching points
  • Take this drug exactly as prescribed. Do not take a higher dosage.
  • Avoid alcohol, sleep-inducing, or over-the-counter drugs; these may cause dangerous effects.
  • You may experience these side effects: Drowsiness, dizziness, blurred vision (avoid driving or engaging in activities that require alertness); dyspepsia (take drug with food; eat frequent small meals); dry mouth (suck sugarless lozenges or ice chips).
  • Report urinary retention or difficulty voiding, pale stools, yellow skin or eyes.