A patient has localized muscle spasms after an injury. The ...

[lak]

A patient has localized muscle spasms after an injury. The prescriber has ordered tizanidine (Zanaflex) to alleviate the spasms.
 
  When obtaining the patient's health history, the nurse should be concerned about which of the following as a possible reason for considering another drug?
  a. Concomitant use of aspirin
  b. A history of hepatitis
  c. A history of malignant hyperthermia
  d. Occasional use of alcohol

Question 2

A nurse is providing teaching to a patient newly diagnosed with partial seizures who will begin taking oxcarbazepine (Trileptal). The patient also takes furosemide (Lasix) and digoxin (Lanoxin).
 
  Which statement by the patient indicates understanding of the teaching?
  a. I may need to increase my dose of Trileptal while taking these medications.
  b. I may develop a rash and itching, but these are not considered serious.
  c. I should report any nausea, drowsiness, and headache to my provider.
  d. I should use salt substitutes instead of real salt while taking these drugs.

[vboyd24]

Answer to Question 1

ANS: B
Hepatotoxicity is a serious potential problem in a patient receiving tizanidine, because the drug can cause liver damage. Baseline liver enzymes should be obtained before dosing and periodically thereafter. Analgesic anti-inflammatory drugs commonly are used in conjunction with centrally acting muscle relaxants, so using aspirin is not a concern. This drug does not contribute to malignant hyperthermia. Patients should be advised to avoid alcohol when taking this drug, but a history of occasional alcohol use is not a contraindication.

Answer to Question 2

ANS: C
Oxcarbazepine can cause clinically significant hyponatremia in 2.5 of patients. If oxcarbazepine is combined with other drugs that reduce sodium, the patient should be monitored. Signs of hyponatremia include nausea, drowsiness, confusion, and headache, and patients should be taught to report these symptoms. Increasing the dose of oxcarbazepine is not indicated. Rashes can indicate a serious drug reaction, and providers should be notified so that the oxcarbazepine can be withdrawn. Salt substitutes would compound the problem of hyponatremia.

[lak]

TYSM

[dantucker]

Excellent