(car-eye-so-PRO-dole)
Soma
Class: Skeletal muscle relaxant/centrally acting

 Action Produces skeletal muscle relaxation, probably as result of its sedative properties.

 Indications Adjunctive treatment of acute, painful musculoskeletal conditions (eg, muscle strain).

 Contraindications Acute intermittent porphyria; hypersensitivity to related compounds such as meprobamate; suspected porphyria.

 Route/Dosage

ADULT: PO 350 mg tid or qid.

 Interactions

Alcohol and other CNS depressants: May cause additive CNS depression.

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: Tachycardia; orthostatic hypotension; facial flushing. CNS: Dizziness; drowsiness; vertigo; ataxia; tremor; agitation; irritability; headache; depressive reactions; syncope; insomnia. GI: Nausea; vomiting; hiccoughs; epigastric distress. OTHER: Allergic or idiosyncratic reactions within first to fourth doses, including skin rash, erythema multiforme, pruritus, eosinophilia and fixed drug eruption; severe reactions include asthma, fever, weakness, dizziness, angioneurotic edema, hypotension and anaphylactoid shock.

 Precautions

Pregnancy: Undetermined. Lactation: Excreted in breast milk. Children: Not recommended in children < 12 yr. Dependency: Use with caution in addiction-prone patients. Renal or hepatic impairment: Use with extreme caution. Tartrazine sensitivity: Some products contain tartrazine, which may cause allergic reactions (including bronchial asthma) in susceptible individuals. Such patients often also have aspirin hypersensitivity.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Give with food or milk if GI upset occurs.
  • Administer last dose at bedtime.
  • Store in tightly closed container in cool, dry place.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note history of porphyria and hypersensitivity or allergy to meprobamate or carisoprodol.
  • Obtain baseline liver function tests, serum BUN and creatinine.
  • Note history of drug dependence.
  • Monitor for signs of idiosyncratic response: disorientation, agitation, vision disturbances, impaired verbal communication, extreme weakness, transient quadriplegia, dizziness, ataxia and euphoria. These reactions may appear within minutes or hours of first dose. Symptoms usually subside over several hours. If such reactions occur, withhold drug and notify physician.
  • Monitor liver function tests, BUN and creatinine.
  • Notify physician if patient experiences hiccough, hives or shortness of breath.
OVERDOSAGE: SIGNS & SYMPTOMS
  Stupor, coma, shock, respiratory depression

 Patient/Family Education

  • Instruct patient to take last daily dose at bedtime.
  • Tell patient to take medication with meals if GI upset occurs.
  • Instruct patient to report these symptoms to physician: palpitations, tremors, hiccough or ataxia.
  • Advise patient to avoid intake of alcoholic beverages or other CNS depressants.
  • Caution patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.

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