tizanidine Nursing Considerations & Management

Drug Name

Generic Name :  tizanidine

Brand Name: Zanaflex

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Classification: Antispasmodic, Sympatholytic, centrally acting

Pregnancy Category C 

Dosage & Route

Available forms: Tablets—2, 4 mg; capsules—2, 4, 6 mg

ADULTS
  • 8 mg PO initial dose; repeat as needed q 6–8 hr; maximum dose, 36 mg/day.
PEDIATRIC PATIENTS
  • Safety and efficacy not established.
PATIENTS WITH RENAL IMPAIRMENT
  • Use lower doses, monitor response.
Therapeutic actions
Indications
  • Acute tizanidine Nursing and intermittent management of increased muscle tone associated with spasticity
Adverse effects of tizanidine Nursing
  • Drowsiness, fatigue, dizziness, insomnia, headache, anxiety, nausea, dryness of mouth, GI disturbances, hypotension, bradycardia, muscle pain and weakness, transient increase in serum transaminases, hallucinations.
  • Potentially Fatal: Hepatitis.
Contraindications
Nursing considerations
Assessment
  • History: Hypersensitivity to tizanidine, clonidine; hepatic or renal impairment, hypotension; pregnancy, lactation
  • Physical: Mucous membranes—color, lesions; orientation, affect; P, BP, orthostatic BP; perfusion; liver evaluation; LFTs, renal function tests
Interventions
  • Administer drug q 6–8 hr around-the-clock for best effects.
  • Adjust drug dosage slowly, which helps to decrease side effects.
  • Continue all supportive measures used for spinal cord–injured or neurologically damaged patients.
  • Provide sugarless lozenges or ice chips, as appropriate, if dry mouth or altered taste occurs.
  • Establish safety precautions if CNS or hypotensive changes occur (use side rails, accompany patient when ambulating).
  • Attempt to lower dose if side effects become severe or intolerable.
Teaching points
  • Take this drug exactly as prescribed. It is important that you not miss doses. Consult your health care provider to determine a schedule that will not interfere with rest.
  • Continue all other supportive measures for your condition.
  • You may experience these side effects: Drowsiness, dizziness, lightheadedness, headache, weakness (use caution while driving or performing tasks that require alertness or physical dexterity); dry mouth (suck on sugarless lozenges or ice chips); GI upset (eat frequent small meals); dizziness, lightheadedness when changing position (rise slowly, use caution when transferring).
  • Report changes in urine or stool, severe dizziness or passing out, changes in vision, difficulty swallowing.