b. Cyclobenzaprine (Flexeril). This skeletal muscle relaxant is usually given
in a dosage of between 20 to 40 milligrams in 2 to 4 divided doses on a daily basis.
Central nervous system depression is the primary side effect of this drug. The patient
taking cyclobenzaprine should be warned that he might experience drowsiness because
of the drug. He should also be warned not to drink alcoholic beverages while taking the
drug. This agent is supplied in tablet form.
c. Orphenadrine Citrate (Norflex). This skeletal muscle relaxant is given in a
dosage of 100 milligrams twice daily. The drug causes central nervous system
depression. The patient should be warned that he might become drowsy while taking
the drug. Furthermore, the patient should be warned not to drink alcoholic beverages
while taking Norflex. Norflex is available in tablet form.
d. Chlorzoxazone (Paraflex, Parafon Forte DSC). This skeletal muscle
relaxant is used as an adjunct to rest, physical therapy, and other measures to relieve
the discomfort associated with acute, painful musculoskeletal conditions. It does not
directly relax tense muscles. Chlorzoxazone has some antianxiety properties and
causes some CNS depression. The patient taking this medication should be warned of
the potential drowsiness and should not drink alcohol while taking this medication. The
usual adult dosage is 250-mg three or four times a day. Initial dosage for painful
musculoskeletal conditions is 500-mg three or four times daily and increased to 750 mg
three or four times daily if needed. Chlorzoxazone is supplied as 250-mg tablets
(Paraflex) and 500-mg tablets (Parafon Forte DSC).
e. Methocarbamol (Robaxin). Methocarbamol is a skeletal muscle relaxant
which is usually administered in a dosage of 1 gram four times daily for muscle spasms.
Since it can produce central nervous system depression, the patient should be warned
of the drowsiness that could accompany its use. When administered intravenously,
methocarbamol is used to treat acute muscle spasms associated with trauma and
inflammation. Methocarbamol is also used in producing skeletal muscle relaxation for
orthopedic procedures when it is administered intravenously.
f. Dantrolene (Dantrium). Dantrolene is a skeletal muscle relaxant that
reduces skeletal muscle tone through a direct effect on muscle contraction. It is
believed that dantrolene affects the uptake of calcium by muscle tissue. This drug is
used to relieve the muscle spasticity associated with such diseases as multiple sclerosis
or cerebral palsy. It is given in oral form initially in a dose of 25 milligrams once or twice
daily; the dosage of the drug is then increased in increments until the desired
therapeutic effect is attained. Although it does not produce its effects on the central
nervous system like the other oral skeletal muscle relaxants, it may cause drowsiness.
You should warn the patient about this potential drowsiness. Dantrolene may also
cause nausea and vomiting. Dantrolene is used in the treatment of malignant
hyperthermia.
MD0805
3-6
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