Nurse Marty is monitoring a client for adverse reactions to dantrolene (Dantrium). Which adverse reaction is most common?
A. Excessive tearing
B. Urine retention
C. Muscle weakness
D. Slurred speech
Correct Answer: C. Muscle weakness
The most common adverse reaction to dantrolene is muscle weakness. The drug also may depress liver function or cause idiosyncratic hepatitis. The intravenous administration of dantrolene in healthy volunteers has resulted in skeletal muscle weakness, dyspnea, respiratory muscle weakness, and decreased inspiratory capacity. These are expected symptoms given the mechanism of action of the medication.
Option A: For those taking the oral capsule for muscle spasticity, liver function tests require monitoring, and dantrolene discontinued if signs and symptoms of liver injury appear. These include elevated LFTs, jaundice, right upper quadrant pain, etc. These symptoms typically resolve upon the discontinuation of dantrolene. If dantrolene is to be reinstated, per recommendations, the patient should be inpatient, and the drug initiated in very small doses with gradual increases.
Option B: Although urine retention is an adverse reaction associated with dantrolene use; they aren’t as common as muscle weakness. When using the lyophilized form of dantrolene, large volumes of sterile water are administered with the medication. Although mannitol is included with the dantrolene, monitoring fluid status and output is paramount to the ongoing care of resuscitation of these patients.
Option D: Muscle weakness is rarely severe enough to cause slurring of speech, drooling, and enuresis. Oral dantrolene carries a black box warning for the potential for hepatotoxicity, including overt hepatitis. Hepatic function should be evaluated before the administration of the oral capsule form and require monitoring throughout the course of treatment. The medication should stop immediately if liver function becomes impaired.
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