Which conditions are contraindications to the administration of barbiturates select all that apply

Carisoprodol (Soma)1 350 mg four times daily
Not recommended for children younger than 12 years Dizziness, drowsiness, headache
Rare idiosyncratic reactions (mental status changes, transient quadriplegia, and temporary loss of vision) after first dose; may require hospitalization
Allergy-type reactions may occur after the first to fourth dose; may be mild (e.g., cutaneous rash) or more severe (e.g., asthma attack, angioneurotic edema, hypotension, or anaphylactic shock); antihistamines, epinephrine, or corticosteroids may be needed Physical or psychological dependence may occur; withdrawal symptoms may occur with discontinuation
Possible respiratory depression when combined with benzodiazepines, barbiturates, codeine or its derivatives, or other muscle relaxants
Contraindicated in acute intermittent porphyria
FDA pregnancy category C $72 to $100 (generic)
$590 (brand) Chlorzoxazone (Parafon Forte)2 Adults: 250 to 750 mg three to four times daily
Children: 125 to 500 mg three to four times daily; or 20 mg per kg daily in three or four divided doses Dizziness, drowsiness
Red or orange urine
GI irritation and rare GI bleeding
Hepatoxicity (rare); discontinue with elevated liver function test Avoid use in patients with hepatic impairment
Possible respiratory depression when combined with benzodiazepines, barbiturates, codeine or its derivatives, or other muscle relaxants
FDA pregnancy category C 15 to 77 (generic)
180 (brand) Cyclobenzaprine (Flexeril)3 5 mg three times daily; may increase to 10 mg three times daily Anticholinergic effect (drowsiness, dry mouth, urinary retention, increased intraocular pressure)
Rare but serious adverse effects are arrhythmias, seizures, myocardial infarction Most studied skeletal muscle relaxant 120 to 140 (generic)
157 (brand) Long elimination half-life 5-mg dose as effective as 10-mg, with fewer adverse effects Avoid in older patients and in patients with glaucoma Possible drug interaction with CYP450 inhibitors Seizures reported with concomitant use of tramadol (Ultram); combination should be avoided in patients with medical conditions that may induce seizures Contraindicated in patients with arrhythmias, recent myocardial infarction, or congestive heart failure FDA pregnancy category B Diazepam (Valium)4 Adults: 2 to 10 mg three to four times daily
Children: 0.12 to 0.80 mg per kg daily in three or four divided doses Dizziness, drowsiness, confusion
Abuse potential Also an antispastic agent 11 to 23 (generic)
184 (brand) Long elimination half-life; avoid in older patients and in patients with hepatic impairment Possible drug interaction with CYP450 inhibitors Complete blood count and liver function tests indicated for prolonged use FDA pregnancy category D; avoid especially in the first trimester Metaxalone (Skelaxin)5 800 mg three to four times daily
Not recommended in children younger than 12 years Drowsiness, dizziness, headache, nervousness
Leukopenia or hemolytic anemia (rare)
Liver function test elevation (rare)
Nausea, vomiting, and diarrhea (rare)
Paradoxical muscle cramps Use with caution in patients with liver failure
Possible respiratory depression when combined with benzodiazepines, barbiturates, codeine or its derivatives, or other muscle relaxants
Less dizziness and drowsiness than other skeletal muscle relaxants
FDA pregnancy category C 275; generic not available Methocarbamol (Robaxin)6 1,500 mg four times daily for first two to three days, followed by 750 mg four times daily Black, brown, or green urine possible
Mental status impairment
Possible exacerbation of myasthenia gravis symptoms Possible respiratory depression when combined with benzodiazepines, barbiturates, codeine or its derivatives, or other muscle relaxants
FDA pregnancy category C; reports of fetal abnormalities 15 to 58 (generic)
176 (brand) Orphenadrine (Norflex)7 100 mg twice daily
Combination products are dosed three to four times daily Anticholinergic effect (drowsiness, dry mouth, urinary retention, increased intraocular pressure)
Aplastic anemia (rare)
GI irritation
Confusion, tachycardia, hypersensitivity reaction (with high doses) Long elimination half-life 110 to 140 (generic)
162 (brand) Reduced dosages in older patients Avoid in patients with glaucoma, cardiospasm, or myasthenia gravis Decreases effect of phenothiazines (e.g., chlorpromazine [Thorazine†], promethazine [Phenergan]) FDA pregnancy category C Tizanidine (Zanaflex)8,9 4 mg initially; may increase by 2 to 4 mg every six to eight hours until relief
Do not exceed 36 mg daily Dose-related hypotension, sedation, and dry mouth
Hepatotoxicity; monitor liver function tests at baseline and one, three, and six months
Withdrawal and rebound hypertension may occur in patients discontinuing therapy after receiving high doses for long period of time; tapering is recommended Also antispastic agent 329 (generic)
437 (brand) Do not use with CYP1A2 inhibitors, ciprofloxacin (Cipro) or fluvoxamine (Luvox CR) Caution with CYP1A2 inhibitors, central nervous system depressants, or alcohol Decreased effectiveness with oral contraceptives FDA pregnancy category C

Which condition is contraindicated for barbiturates?

Which group should not be given barbiturates?

Which medication can the nurse anticipate will be given for an overdose of a barbiturate?

What conditions do barbiturates treat?