Page 2149 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 61

Musculoskeletal Medications

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Priority Concepts
Inflammation; Safety

I. Skeletal Muscle Relaxants
A. Description
1. Skeletal muscle relaxants (Box 61-1) act directly on the
neuromuscular junction or act indirectly on the
central nervous system (CNS).
2. Centrally acting muscle relaxants depress neuron
activity in the spinal cord or brain.
3. Peripherally acting muscle relaxants act directly on the
skeletal muscles, interfering with calcium release
from muscle tubules and thus preventing the fibers
from contracting.
4. Skeletal muscle relaxants are used to prevent or relieve
muscle spasms and treat spasticity associated with
spinal cord disease or lesions, acute painful
musculoskeletal conditions, and chronic debilitating
disorders such as multiple sclerosis, stroke (brain
attacks), or cerebral palsy.

5. Skeletal muscle relaxants are contraindicated

in clients with severe liver, renal, or heart disease;
these medications are often metabolized in the liver or
excreted by the kidneys.

6. Skeletal muscle relaxants should not be taken

with CNS depressants, such as barbiturates, opioids,
alcohol, sedatives, hypnotics, or tricyclic
antidepressants, unless specifically prescribed.
B. Side and adverse effects
1. Dizziness and hypotension

2. Drowsiness and muscle weakness

3. Dry mouth
4. Gastrointestinal upset

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