Baclofen: Nursing Considerations and Management
巴氯芬：护理考虑及管理
Baclofen is an antispastic. It inhibits both monosynaptic and polysynaptic reflexes at spinal level.
巴氯芬是解痉药，抑制脊髓层面的单突触和多突触反射。
Indications 适应症
Alleviation of signs and symptoms of spasticity resulting from MS, particularly for the relief of flexor spasms and concomitant pain, clonus, muscular rigidity (for patients with reversible spasticity to aid in restoring residual function); treatment of central spasticity (via SynchroMed pump)
Spinal cord injuries and other spinal cord diseases—may be of some value
脊髓损伤和其他脊髓疾病可能有用
Unlabeled uses: Trigeminal neuralgia (tic douloureux); may be beneficial in reducing spasticity in cerebral palsy in children (intrathecal use)
标示外使用：三叉神经痛（三叉神经痛）；可能有助于减少儿童脑瘫的痉挛（鞘内使用）
Patients given implantable device for intrathecal delivery need to learn about the programmable delivery system, frequent checks; how to adjust dose and programming.
通过植入装置鞘内注射的患者必须学会使用可编程的输送系统，并经常检查。如何调节剂量和编程
Give with caution to patients whose spasticity contributes to upright posture or balance in locomotion or whenever spasticity is used to increase function.
痉挛状态有助于保持行进时直立或平衡或随时需要利用痉挛状态增强功能的患者需谨慎用药
BLACK BOX WARNING: Taper dosage gradually to prevent hallucinations, possible psychosis, or other serious effects; abrupt discontinuation can cause serious reactions.
黑框警示：逐渐减少剂量，预防幻觉、可能的重性精神病或其他严重效应；突然停药可能引起严重反应
Teaching points 宣教要点
Take this drug exactly as prescribed. Do not stop taking this drug without consulting your health care provider; abrupt discontinuation may cause hallucinations or other serious effects.
按说明正确用药。未咨询医疗保健服务人员不得服药；突然停药可能引起幻觉或其他严重效应
Avoid alcohol, sleep-inducing, or over-the-counter drugs because these could cause dangerous effects.
避免饮酒、诱导睡眠或非处方药，因为这些行为可能引起危险效应
Do not take this drug during pregnancy. If you decide to become pregnant or find that you are pregnant, consult your health care provider.
妊娠期间不要服药。若决定怀孕或发现怀孕，应咨询医疗保健服务人员
You may experience these side effects: Drowsiness, dizziness, confusion (avoid driving or engaging in activities that require alertness); nausea (eat frequent small meals); insomnia, headache, painful or frequent urination (effects reversible; will go away when the drug is discontinued).
Report frequent or painful urination, constipation, nausea, headache, insomnia, or confusion that persists or is severe.
报告持续性或严重的尿频或尿痛、便秘、恶心、头痛、失眠或意识错乱
★Vocabulary ★
baclofen – n. 巴氯芬
antispastic – n. a. 解痉的，解痉药
monosynaptic – a. 单突触的
polysynaptic – a. 多突触的
flexor – n. 屈肌
concomitant – a. 伴随的，共存的
clonus – n. 阵挛
residual function – 残存功能
SynchroMed pump – 自动定时给药泵
unlabeled – a. 未贴标签的，未标记的
unlabeled uses – 标示外使用
trigeminal neuralgia – 三叉神经痛
trigeminal – a. 三叉（神经）的
neuralgia – n. 神经痛
tic douloureux – n. 三叉神经痛
palsy – n. 麻痹（状态），瘫痪
cerebral palsy – 脑瘫
intrathecal – a. 鞘内的，硬膜内的
enuresis – n. 遗尿
LFTs – n. liver function tests肝功能试验
locomotion – n. 行进，移动，转位
taper – v. 逐渐减少、变小
1. Which of the following is the priority nursing intervention for children receiving muscle relaxants?
A. Assess bowel sounds and activity.
B. Provide skin care.
C. Administer drug with food.
D. Both A and B.
2. A mother brings her 9-year-old son to the clinic for a routine check-up. The 9-year-old boy has cerebral palsy and is very spastic. The mother asks the nurse what causes the spasticity in her son. What is the nurse’s best response? A. Your son’s spasticity is caused by injury to the muscle tissue. B. Your son’s spasticity is caused by deficiency of a neurotransmitter called serotonin. C. Your son’s spasticity is caused by damaged sensory neurons. D. Your son’s spasticity is caused by damaged motor neurons.
奥医教育“在线自测”正式上线，复习练习、效果检验，奥医NCLEX-RN/ISPN题库一站完成
答案 Answers
1. A. Assess bowel sounds and activity. Rationale: Children are especially at an increased risk of CNS and GI toxicity. 2. D. Your son’s spasticity is caused by damaged motor neurons. Rationale: Muscle spasticity is the result of damage to neurons within the central nervous system (CNS) rather than injury to peripheral structures such as the musculoskeletal system. Serotonin is not involved in the process of muscle contraction and relaxation. Although acetylcholine is released and increases muscle cell membrane permeability to sodium, which eventually leads to the release of calcium, this process does play a vital part in muscle contraction and relaxation.
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