Muscle relaxants 781
CV:
hypotension, hypertension.
ENT:
nasal congestion, slurred speech.
Eye:
blurred vision.
GI:
nausea,
constipation,
vomiting.
GU:
urinary frequency.
Hepatic:
increased AST and alkaline phos
phatase levels.
Metabolic:
hyperglycaemia, weight gain.
Respiratory:
dyspnoea.
Skin:
rash, pruritus, excessive sweating.
Interactions
Drug-drug.
Antihypertensives:
Additiveeffects.
Adjust antihypertensive dosage accordingly.
CNS depressants:
Increased CNS depression.
Avoid use together.
Levodopa/carbidopa:
Possible mental
confusion, hallucinations, headaches,
nausea and agitation. Monitor closely.
Lithium:
Aggravatedhyperkineticsymptoms.
Monitor closely.
MAO inhibitors:
Increased CNS depression
and hypotension. Use cautiously and
consider reduced dose.
Tricyclic antidepressants:
Increased effects of
baclofen and increasedmuscular hypotonia.
Monitor closely.
Drug-lifestyle.
Alcohol use:
Increased CNS
depression. Advise person to avoid alcohol
use.
Contraindications
Contraindicated in individualshypersensitive
to drug.
care considerations
• Use cautiously in individuals with
impaired renal function or seizure disorders
or when spasticity is used tomaintainmotor
function.
• Consider reduced dose in elderly adults
and in individuals with renal impairment.
• Give oral form with meals or with milk to
prevent GI distress.
• Orally administered drug should not
be used to treat muscle spasm caused
by rheumatic disorders, cerebral palsy,
Parkinson’s disease or CVA because efficacy
has not been established.
• Do not administer intrathecal injection
by IV, IM, SC or epidural route.
• Watch for sensitivity reactions, such
as fever, skin eruptions and respiratory
distress.
• Anticipate increased risk of seizures in
individuals with seizure disorder.
• Amount of relief determines whether
dosage (and drowsiness) can be reduced.
• Do not withdraw drug abruptly after
long-term use unless required by adverse
reactions; may trigger hallucinations or
rebound spasticity.
• Experience with long-term intrathecal
use suggests that about 10% of individuals
may develop tolerance to drug. In some
cases, this may be treated by hospitalising
person and slowly withdrawing drug over
2-week period.
Patient teaching
• Instruct person to take oral form with
meals or milk to prevent GI distress.
• Advise person to avoid activities that
require alertness until drug’s CNS effects
are known. Drowsiness is usually transient.
• Advise person to avoid alcohol when
taking drug.
• Instruct person to follow prescriber’s
orders regarding rest and physical therapy.
dantrolene sodium
Dantrium, Dantrium IV
Pregnancy risk category B2
Use in sport: Permitted
Available forms
Capsules:
25 mg, 50 mg
Powder for injection:
20 mg/vial
Indications & dosages
➤
Spasticityandsequelaesecondarytosevere
chronic disorders (such as multiple sclerosis,
cerebral palsy, spinal cord injury, CVA)—
Adults:
25mg PO daily. Increased gradually
in 25-mg increments, up to 100 mg b.i.d. to
q.i.d., to maximum of 400 mg daily.
