McKenna's Drug Handbook for Nursing & Midwifery, 7e

Muscle relaxants     783

Action Antimuscarinic. Antispasmodic and smooth muscle relaxant. Route Onset Peak Duration PO Unknown 13 hrs 24 hrs Adverse reactions CNS: dizziness, headache, insomnia, malaise. CV: bradycardia. GI: nausea, constipation, dyspepsia, heartburn. Metabolic: anorexia. Skin: facial oedema, urticaria. Other: angio-oedema , anaphylaxis , hyper- sensitivity reaction. Interactions None reported. Contraindications Contraindicated in individuals with hyper­ sensitivity to the drug or other components of the preparation and in those with severe hepatic impairment. care considerations • Use cautiously in individuals with cardiac arrhythmia, heart block, angina, ischaemic heart disease or liver or renal impairment. • Liver function tests should be performed regularly in individualswith liver impairment. • Preparation contains lactose and sucrose so caution is required in individuals with potential intolerance or relevantmalabsorp­ tion syndrome. • Not recommended in the first trimester of pregnancy. Patient teaching • Advise person to take drug at the same time each day, 20 minutes before meals. • Warn person to avoid driving and other hazardous activities until CNS effects of drug are known. • Instruct person to continue taking the medication, even if feeling well.

• Obtain liver function test results at begin­ ning of therapy. • Prepare oral suspension for single dose by dissolving capsule contents in juice or other liquid. For multiple doses, use acid vehicle and refrigerate. Use within several days. • Watch for hepatitis (fever and jaundice), severe diarrhoea, severe weakness or sensit­ ivity reactions (fever and skin eruptions). Withhold dose and notify prescriber if these occur. • Amount of relief in individual determines whether dosage (and drowsiness) can be reduced. Patient teaching • Instruct person to take drugwithmeals or milk in four divided doses. • Advise person to use cautionwhen eating to avoid choking. Some individuals may experience difficulty swallowing during therapy. • Warn person to avoid driving and other hazardous activities until CNS effects of drug are known. • Advise person to avoid combining drug with alcohol and other CNS depressants. • Instruct person to avoid photosensitivity reaction by using sunblock and wearing protective clothing, to report abdominal discomfort or GI problems immediately and to follow prescriber’s orders regarding rest and physical therapy. mebeverine hydrochloride Colese, Colofac Pregnancy risk category B2 Use in sport: Permitted Available form Tablets: 135 mg Indications & dosages ➤ Managementofirritablebowelsyndrome— Adults: 135 mg PO t.i.d.