Alternate Name(s):
ISMELIN
Classification:
Sympathetic inhibitor
Original Date:
October 2007
Indications:
- Regional sympathetic blockade for the treatment of reflex sympathetic dystrophy syndrome
Reconstitution and Stability:
- Available as a 10 mg/mL clear colourless solution
- Protect from light
- Use immediately after diluting
Compatibility:
-Solutions Compatible: 0.9% NaCl
-Additives/Above Cassette Compatible: heparin, lidocaine
-Y-site Compatible: no information
Incompatible: not information
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct | NO |
| IV Intermittent Infusion |
YES, physician must be present , BP monitoring Usual dilution: 0.4 - 0.8 mg/mL Infusion time: 15 minutes |
| IV Continuous Infusion | NO |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Adolescent/Adult:
- Arm : 10-20 mg
- Leg: 20-30 mg
- Dose and volume of injection may be reduced if the tourniquet is applied more distally on the limb
-can be given alone or combined with heparin:
- 10-20 mg with heparin 500 international units qs 25 mL with NS
- 20-30 mg with heparin 1,000 international units qs 50 mL with NS
Potential hazards of parenteral administration:
- Apnea
- Hypotension or paradoxical hypertension
- Transient exacerbation of pain on injection -may be used with lidocaine 1-2mg/kg
- Diarrhea
- Hyperglycemia, fluid retention
Notes:
- Should be done by personnel experienced in the use of regional blocks
- Monitor blood pressure
- Infusion into regional vein, using tourniquet to limit systemic effect -slowly deflate to regulate release of unincorporated guanethidine
- Contraindicated in patients with pheochromocytoma, heart block greater than first degree, congestive heart failure or malignant ventricular arrhythmias
- DO NOT use concurrently with or within 1 week of MAO inhibitors