Is this possible?? - page 2

by Racer15

3,452 Unique Views | 17 Comments

I had a patient refuse the Norflex the doctor had ordered, as they said they were allergic to Flexaril. They said it gave them muscle spasms?! But then promptly asked if I could get the doctor to order another muscle relaxer. ... Read More


  1. 1
    I had a patient once who stated she was allergic to saline flushes.
    marycarney likes this.
  2. 0
    Quote from sKris
    I had a patient once who stated she was allergic to saline flushes.
    Especially when it needs to dilute a narc???? LOL

    I am allergic to unicorns and rainbows.......
  3. 3
    Quote from Racer15
    Yeah, I knew it wasn't a true allergy, but when I asked my preceptor about it, he said it was impossible for a muscle relaxer to cause increased muscle spasms. The patient was asking me if Norflex was in the same category as Flexaril and I said well, yeah. I was just wondering if anyone had ever heard of muscle relaxers doing this to anyone else, my preceptor just figured this patient was drug seeking as they had had 1mg of Dilaudid less than an hour before.
    Not true, your preceptor is mistaken.....Norflex can cause in some people a condition called tartive dyskensia.
    is characterized by repetitive, involuntary, purposeless movements. Some examples of these types of involuntary movements include grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking. Rapid, involuntary movements of the limbs, torso, and fingers may also occur.In some cases, an individual's legs can be so affected that walking becomes difficult or impossible.
    http://emedicine.medscape.com/article/1151826-overview medscape requires registration but it is FREE and an excellent resource/source

    Anti-cholinergics

    Anti-cholinergics (anti-spasmodics) are class of medications prescribed for respiratory problems such as COPD, bladder control problems, Parkinson’s disease, and other reasons. The following anti-cholinergics have commonly been given to help control some symptoms of Parkinson’s, but these drugs can cause tardive dyskinesia:
    • Benzhexol
    • Biperiden (brand name: Akineton)
    • Ethopropazine
    • Orphenadrine (brand names: Norflex, Norgesic, Orphengesic)
    • Procylindine
    Sadala, Vespertinas, and jadelpn like this.
  4. 0
    Tardive Dyskenisia is a really serious side effect. And has to be treated as such as to not have permenant effects.
  5. 1
    Quote from tewdles
    So the patient doesn't tolerate a med well and has asked for another...why is this an issue?

    I guess I don't understand the question.
    It doesn't really matter at this point if the reaction is an allergic response or an intolerance or a paradoxical effect...the patient doesn't want to take it because of the way it affected him and has requested another. That seems a perfectly reasonable thing to me.

    Am I missing something?
    You aren't missing anything. I've been an RN for two months, my preceptor (RN for three years) and another nurse that has been an LPN for many many more, both told me this was an impossible side effect and that this patient was drug seeking. I did not feel comfortable questioning their judgement, as I am still in orientation. I was also not aware that muscle relaxers could cause tardive dyskenisia, as in school it was only related to psych drugs, so thank you!
    Esme12 likes this.
  6. 1
    Quote from Racer15

    You aren't missing anything. I've been an RN for two months, my preceptor (RN for three years) and another nurse that has been an LPN for many many more, both told me this was an impossible side effect and that this patient was drug seeking. I did not feel comfortable questioning their judgement, as I am still in orientation. I was also not aware that muscle relaxers could cause tardive dyskenisia, as in school it was only related to psych drugs, so thank you!
    Always question people if you don't agree!
    Esme12 likes this.
  7. 0
    Also - gastro drugs are implicated in tardive dyskenesia, including
    Reglan
    Compazine
    Propulsid

    And norflex has caused dystonia in a handful of reported pts
  8. 0
    I had a horrible reaction to compazine - td. Before i was a nurse. It was my first pregnancy and my husband and I were terrified. I have seen a similar reaction to Flexeril. It was a while ago. Pt put on Soma with no problems.


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