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Acute Neuro

Skeletal Muscle Relaxants/ Cerebral Edema

QuestionAnswer
What are skeletal muscle relaxant drugs? baclofen (Lioresal) Dantrolene (Dantrium)
Where does baclofen (Lioresal) work at in the body? Centrally acting in the brain
What is the indication for baclofen (Lioresal) ? MS, cerebral palsy, SCI - spasticity
What is the mechanism of action of baclofen (Lioresal)? * Unknown thought to mimic action of GABA (inhibitory neurotransmitter) on spinal neurons-CNS * Suppress hyperactive reflexes, decrease spasticity and increase performance
What are the SE of baclofen (Lioresal)? CNS depressant - dizziness, drowsiness, weakness and fatigue
What are the nursing consideration for baclofen (Lioresal)? Take w/ food or milk * Caution about stopping abruptly – hallucinations. * Watch driving, no ETOH
Where does Dantrolene (Dantrium) work at in the body? Directly-acting skeletal muscle
What is the indication for Dantrolene (Dantrium)? MS, cerebral palsy, SCI - spasticity
What is the mechanism of action of Dantrolene (Dantrium)? *Suppressing calcium from sarcoplasmic reticulum- in muscle * Causes reduction in muscle strength and overall function (negative)
What is the nursing considerations for Dantrolene (Dantrium)? * Report fatigue, malaise, CNS changes. * Avoid driving, ETOH
What is the benzodiazepine used for relaxing muscles? Diazepam (Valium)
What is Diazepam (Valium) used for? MS, cerebral palsy, SCI - spasticity
What is the mechanism of action for Diazepam (Valium)? CNS depression Mimic the actions of GABA-(inhibitory neurotransmitter)
What is the SE of Diazepam (Valium)? CNS depressant – lethargy, sedation, respiratory depression
What are hyperosmolar agents? Hypertonic sodium chloride 2-3% Sodium chloride 7.5% Sodium chloride
What do hypertonic sodium chloride used for? Cerebral Edema
What is the mechanism of action used for hypertonic sodium chloride? Pulls water from ECF fluid space into IVF space. *Reduce brain swelling by increasing the sodium levels in the blood stream; thereby pulling fluid from edematous brain.
What is the SE for hypertonic sodium chloride? FVE, refractory intracranial hypertension * Pulmonary edema
What is the nursing considerations for hypertonic sodium chloride? Monitor I&O * Monitor sodium levels. * Monitor respiratory status
What is an osmotic diuretic? Mannitol (Osmitrol)
What is mannitol used for? Cerebral Edema
What is the mechanism of action of mannitol? Decreases ICP by: Entering brain capillaries. Does not cross capillary membrane in brain, creating osmotic gradient that moves fluid into the vascular structures…but does cross ALL other capillary membranes.
What is the SE of mannitol? Seizures, headache * May precipitate heart failure, pulmonary edema *Electrolyte imbalances may occur.
What is the nursing considerations for mannitol? Used cautiously in patients with HF, renal disease *Watch for crystallization of solution due to cold environs – use filter needle and IV tubing with in-line filter. * Avoid extravasation
Created by: Amberwill