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Nursing Notes and Community Drug Name Dosages Generic Name : Adults cyclobenzaprine hydrochloride 5 mg PO tid, 10 mg PO tid (range 2040 mg/day in Brand Name: Apodivided doses); do not Cyclobenzaprine exceed 60 mg/day; do not (CAN), Flexeril, use longer than 2 or 3 wk. Novo-Cycloprine (CAN) Classification: Skeletal muscle relaxant (centrally acting) Pregnancy Category B Pediatric Patients 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

Safety and efficacy in patients < 15 yr not established.

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, sleepinducing, or over-thecounter 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.

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