Pain and Mobility
10.8 Adjuvant Analgesics
Medications used as adjuvant analgesics were developed for other purposes but were later found to be effective to treat pain. Examples of adjuvant medications include gapapentin (an anticonvulsant) and amitriptyline (a tricyclic antidepressant). Additional information about these specific medications can be found in Chapter 8. Muscle relaxants are also considered an adjuvant analgesic and are used for various musculoskeletal disorders such as multiple sclerosis. Three different types of muscle relaxants will be discussed below baclofen, cyclobenzaprine, and tizanidine.
Baclofen
Mechanism of Action
Baclofen inhibits reflexes at the spinal level.
Indications for Use
Baclofen is used to treat muscle symptoms, such as spasms, pain, and stiffness, caused by multiple sclerosis, spinal cord injuries, or other spinal cord disorders.
Nursing Considerations Across the Lifespan
Baclofen is safe for clients 12 years and older.
Adverse/Side Effects
Adverse effects include drowsiness, dizziness or lightheadedness, confusion, nausea, constipation, and muscle weakness.
Abrupt Drug Withdrawal: Hallucinations and seizures have occurred on abrupt withdrawal of baclofen. Therefore, except for serious adverse reactions, the dose should be reduced slowly when the drug is discontinued.
Impaired Renal Function: Because baclofen is primarily excreted unchanged through the kidneys, it should be given with caution, and it may be necessary to reduce the dosage.
Signs and symptoms of overdose include vomiting, muscular hypotonia, drowsiness, accommodation disorders of the eye, coma, respiratory depression, and seizures.
Client Teaching & Education
The medication should be taken as directed and abrupt withdrawal of the medication should be avoided. It may cause dizziness or drowsiness. Clients should be advised to change positions slowly because of the potential orthostatic changes that may occur. Additionally, clients should avoid concurrent use with alcohol or other CNS depressants.
Baclofen Medication Card
Now let’s take a closer look at the medication card for baclofen[1] Medication cards like this are intended to assist students to learn key points about each medication. Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication. Basic information related to each class of medication is outlined below. Prototype or generic medication examples are also hyperlinked to a free resource at Daily Med. On the home page, enter the drug name in the search bar to read more about the medication.
Medication Card 10.8.2: Baclofen
Generic Name: baclofen
Prototype/Brand Name: APO-Baclofen
Mechanism: inhibits reflexes at the spinal level.
Therapeutic Effects
- Inhibition of spasticity and muscle stiffness
- Reduction of pain
Administration
- Baclofen is safe for clients 12 years and older.
- Do not take this drug dur