Skeletal muscle relaxants act directly no the neuromuscular junction or act indirectly on the CNS. Centrally acting muscle relaxants depress neuron activity in the spinal cord or brain. Peripherally acting muscle relaxants act directly on the skeletal muscles, interfering with calcium release from muscle tubules and thus preventing the fibers from contracting.
Instruct the client to take the medication with food to decrease GI upset. Instruct the client to avoid alcohol and CNS depressants. Instruct the client to avoid activities requiring alertness, such as driving or operating equipment. Safety is a primary concern when the client is taking a skeletal muscle relaxant because these medications cause drowsiness. Monitor liver function test when a client is taking a skeletal muscle relaxant because hepatotoxicity can occur.
2. ★ antigout medications
Antigout medications reduce uric acid production and increase uric acid excretion to prevent or relieve gout or to manage hyperuricemia.
ex) allopurinol (Zylopim), colchicine (Colcrys)
side/adverse effects: nausea, vomiting, diarrhea, headache, dizziness, flushed skin and rash, blood dyscrasias such as bone marrow depression, uric acid kidney stones, sore gums, metallic taste
Maintain a fluid intake of at least 2000 to 3000 mL/day to prevent kidney stones. Instruct the client to avoid alcohol and caffeine because these products can increase uric acid levels. Instruct the client to avoid foods high in purine as prescribed, such as wine, alcohol, organ meats, sardines, salmon, scallops, and gravy. Instruct the client not to take large doses of vitamin C while taking allopurinol because kidney stones may occur. Instruct the client to take the medication with food to decrease gastric irritation. (colchicine 복용 시 If GI symptoms occur, the medication is withheld and the HCP is notified.) Encourage the client to comply with therapy to prevent elevated uric acid levels, which can trigger a gout attack. (allopurinol 400 to 600 mg/day up to 800 mg, 단 300 mg 씩 나누어서 복용, 이후 100 to 200 mg bid or tid) (colchicine 1.2 mg first → 통증완화까지 0.6 mg 씩 q1hr → 0.5 mg bid) Caution the client not to take aspirin with these medications because this could trigger a gout attack.
