For an older adult starting cyclobenzaprine, which assessment should be prioritized?

• A. Blood pressure monitoring
• B. Sedation level
• C. Visual acuity testing
• D. Lung function tests

Answer: (B)

Older adults are particularly susceptible to central nervous system depressants, so the priority when starting cyclobenzaprine is monitoring sedation. This medication can cause drowsiness, dizziness, and slowed reaction times, and aging amplifies these effects because of changes in distribution, metabolism, and concurrent medications. If sedation becomes significant, the risk of falls, confusion, and impaired functioning increases substantially, making it essential to assess how sleepy or impaired the patient feels and to adjust the dose or discontinue if needed. This focused monitoring helps keep safety first, guiding decisions about activities, driving, and potential drug interactions with other sedatives or alcohol. While blood pressure, vision, and lung function are important in various clinical contexts, they are not the primary concerns with cyclobenzaprine initiation in an older adult compared to the direct impact of sedation on safety.