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[h]

Musculoskeletal and sleep

[q] Succinylcholine

[a] Neuromuscular blocking agents block acetylcholine- resulting in muscle relaxation and hypotension

[q] Succinylcholine adverse effect

[a] Respiratory arrest, Hypotension, malignant hyperthermia, Hyperkalemia

[q] Centrally acting muscle relaxants

[a] Diazepam, Baclofen, Cyclobenzaprine, Tizanidine

[q] Peripherally acting muscle relaxants

[a] Dantrolene

[q] Diazepam, cyclobenzaprine, tizanidine side effect

[a] CNS depression, Hepatic toxicity, dependence

[q] Baclofen side effect

[a] CNS depression, Nausea, constipation, urinary retention (increase intake of high-fiber foods, I/O)

[q] Dantrolene side effect

[a] Hepatic toxicity, Muscle weakness

[q] Oxybutynin

[a] Prevents contractions of the bladder and the urge to void

[q] Oxybutynin side effect

[a] Anticholinergic effects (constipation, dry mouth, blurred vision,photophobia, dry eyes) – increase dietary fiber, consume 2 to 3 L/day of fluid from beverage and food sources, sip fluids, and avoid , sip fluids, and avoid hazardous activities if vision is impaired) › CNS effects (hallucinations confusion, insomnia, nervousness)

[q] Oxybutynin interaction

[a] Contraindicated in clients who have glaucoma, myasthenia gravis, paralytic ileus, GI or GU obstruction, or urinary retention.

[q] Zolpidem, Zaleplon, Eszopiclone, Trazodone

[a] Sleep medication – management of insomnia- Daytime sleepiness and lightheadedness may occur – take med at bedtime

[q] Ramelteon

[a] Melatonin Agonist – activate melatonin- help with sleep

[q] Ramelteon Side Effect

[a] Sleepiness, dizziness, fatigue, Hormonal effects (amenorrhea, decreased libido, infertility, galactorrhea)

[q] Ramelteon and food

[a] High-fat meals and grapefruit juice increase absorption. Take medication on an empty stomach.

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