ISOXSUPRINE HYDROCHLORIDe (eye-sox'syoo-preen)
Vasodilan, Voxsuprine Classifications: beta-adrenergic agonist; vasodilator; Therapeutic: vasodilator; beta-adrenergic agonist; alpha-adrenergic inhibitor Prototype: Albuterol Pregnancy Category: C
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Availability
10 mg, 20 mg tablets
Action
Sympathomimetic with beta-adrenergic stimulant activity and with an inhibitory effect on alpha receptors. Vasodilating action
on arteries within skeletal muscles is greater than on cutaneous vessels.
Therapeutic Effect
Has both cerebral and peripheral vasodilatory properties.
Uses
Adjunctive therapy in treatment of cerebral vascular insuf-ficiency and peripheral vascular disease, such as arteriosclerosis
obliterans, thromboangiitis obliterans (Buerger's disease), and Raynaud's disease.
Contraindications
Immediately postpartum; presence of arterial bleeding; parenteral use in presence of hypotension, fetal distress; intrauterine
fetal death; vaginal bleeding; tachycardia; pregnancy (category C).
Cautious Use
Bleeding disorders; severe cerebrovascular disease, severe obliterative coronary artery disease, recent MI; lactation.
Route & Dosage
Cerebral Vascular Insufficiency, Peripheral Vascular Disease Adult: PO 1020 mg t.i.d. or q.i.d.
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Administration
Oral
- When used with premature labor: Do not give immediately after delivery because it causes uterine relaxation, or in the presence
of arterial bleeding.
Adverse Effects (≥1%)
CV: Flushing, orthostatic hypotension with light-headedness, faintness; palpitation, tachycardia.
CNS: Dizziness, nervousness, trembling, weakness.
GI: Nausea, vomiting, abdominal distress, abdominal distention.
Pharmacokinetics
Absorption: Readily from GI tract.
Peak: 1 h.
Duration: 3 h.
Distribution: Crosses placenta.
Metabolism: In blood.
Elimination: In urine.
Half-Life: 1.25 h.
Nursing Implications
Assessment & Drug Effects
- Monitor for therapeutic effectiveness: Response to treatment of peripheral vascular disorders may take several weeks. Evaluate
clinical manifestations of arterial insufficiency.
- Monitor BP and pulse; may cause hypotension and tachycardia. Supervise ambulation.
- Observe both mother and baby for hypotension and irregular and rapid heartbeat if isoxsuprine is used to delay premature
labor. Hypocalcemia, hypoglycemia, and ileus have been observed in babies born of mothers taking isoxsuprine.
Patient & Family Education
- Notify physician of adverse reactions (skin rash, palpitation, flushing) promptly; symptoms are usually effectively controlled
by dosage reduction or discontinuation of drug.
- Prevent orthostatic hypotension by making position changes slowly and in stages, particularly from lying down to sitting
upright and avoid standing still.
- Note: For treatment of menstrual cramps, isoxsuprine is usually started 13 d before onset of menstruation and continued
until pain is relieved or menstrual flow stops.