The nurse is discharging a 72-year-old man who was hospitalized after a muscle strain injury to his back. One of the discharge prescriptions for this patient is cyclobenzaprine (Flexeril) 10 mg three times per day with food
The prescription is written for 90 tablets and there are three refills available. Which information from this situation would alert the nurse for the need to collaborate with the patient's health care provider?
1. The dosage amount is too low for the type of injury this patient sustained.
2. Cyclobenzaprine should be used with great caution in those over 65.
3. If taken as directed, the patient would be able to take the medication for 120 days.
4. Cyclobenzaprine is not effective for back pain.
5. Cyclobenzaprine should not be taken with food.
Correct Answer: 2,3
Rationale 1: The dosage of 10 mg three times daily is standard.
Rationale 2: The adverse reactions from cyclobenzaprine include confusion, hallucinations, and cardiac events, which are more common in patients over 65.
Rationale 3: The manufacturer recommends that treatment not extend beyond 3 weeks or 21 days.
Rationale 4: Cyclobenzaprine is not effective for muscle spasm due to spinal cord injury, but is useful in the treatment of back pain from muscle strain.
Rationale 5: The drug may be taken with food or milk if gastric upset occurs.
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