Chapter 44: Drugs Used to Treat the Musculoskeletal System Clayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition

1. A patient who has undergone a lengthy surgical procedure under general anesthesia is unable to breathe on his own following the procedure. Which drug will the nurse expect to be administered as an antidote to the neuromuscular-blocking agent? a. Dantrolene (Dantrium) b. Neostigmine methylsulfate (Prostigmin) c. Ether d. Baclofen (Lioresal) ANS: B Neostigmine methylsulfate is an antidote to neuromuscular-blocking agents. Additional measures to implement include artificial respirations with oxygen and atropine sulfate for bradycardia and hypotension. Dantrolene is a direct-acting skeletal muscle relaxant given for the treatment of neuroleptic malignant syndrome associated with the use of antipsychotic agents. Ether is a general anesthetic. Baclofen is a skeletal muscle relaxant. DIF: Cognitive Level: Application REF: Page 684 OBJ: 4 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Safety; Gas Exchange 2. What is the reason for a paraplegic patient to receive baclofen (Lioresal)? a. It interrupts reflexes at the level of the spinal cord. b. It acts directly on the skeletal muscles to reduce spasticity. c. It interrupts transmission of impulses from motor nerves to muscles at the skeletal neuromuscular junction. d. It produces generalized mild weakness of skeletal muscles and decreases the force of reflex muscle contractions. ANS: A Baclofen is a gamma aminobutyric acid derivative that interrupts polysynaptic reflexes at the level of the spinal cord. Baclofen does not appear to act directly on the skeletal muscles. Interrupting transmission of impulses from motor nerves to muscles at the skeletal neuromuscular junction is the mechanism of action of neuromuscular-blocking agents. Producing generalized mild weakness of skeletal muscles and decreasing the force of reflex muscle contractions is the mechanism of action of dantrolene. DIF: Cognitive Level: Comprehension REF: Page 682 OBJ: 2 | 3 TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: P