Home Drug Guide Guanadrel Sulfate

Drug Guide

Generic Name

Guanadrel Sulfate

Brand Names Hylorel

Classification

Therapeutic: Antihypertensive, Sympatholytic agent

Pharmacological: Adrenergic neuron blocker

FDA Approved Indications

  • Hypertension (used to be approved but may no longer be in common use; consult current guidelines)

Mechanism of Action

Guanadrel sulfate inhibits sympathetic postganglionic neurons, reducing norepinephrine release, leading to decreased sympathetic activity and lowering blood pressure.

Dosage and Administration

Adult: Typically 20 mg twice daily, adjusted based on response.

Pediatric: Not generally used in pediatric populations.

Geriatric: Initial dose may be lower; monitor for orthostatic hypotension.

Renal Impairment: Adjust dose based on renal function; closely monitor blood pressure.

Hepatic Impairment: Use with caution; no specific adjustment established.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract.

Distribution: Widely distributed; crosses the blood-brain barrier to some extent.

Metabolism: Minor hepatic metabolism, primarily excreted unchanged.

Excretion: Primarily via urine.

Half Life: Approximately 7-8 hours.

Contraindications

  • History of hypersensitivity to guanadrel sulfate or related drugs.

Precautions

  • Use with caution in patients with orthostatic hypotension, renal impairment, or cerebrovascular disease.

Adverse Reactions - Common

  • Postural hypotension (Frequent)
  • Gastrointestinal disturbances (nausea, diarrhea) (Occasional)

Adverse Reactions - Serious

  • Agranulocytosis, hemolytic anemia (Rare)
  • Severe hypotension or hypertensive crisis (Rare)

Drug-Drug Interactions

  • Other antihypertensives, sympathomimetics, MAO inhibitors

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure and heart rate regularly. Watch for signs of hypotension and adverse hematologic reactions.

Diagnoses:

  • Risk for falls related to hypotension.
  • Impaired tissue perfusion.

Implementation: Administer as ordered, typically in divided doses. Educate patient on symptoms of hypotension.

Evaluation: Assess effectiveness via blood pressure measurements and symptom control.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Rise slowly from sitting or lying position to prevent dizziness.
  • Report symptoms of weakness, sore throat, fever, or unusual bleeding.

Special Considerations

Black Box Warnings:

  • Potential for hematologic reactions such as agranulocytosis; monitor blood counts regularly.

Genetic Factors: None specific.

Lab Test Interference: May affect blood glucose or hematologic tests.

Overdose Management

Signs/Symptoms: Se severe hypotension, dizziness, bradycardia.

Treatment: Supportive care, vasopressors if needed, and IV fluids. Remove the offending agent.

Storage and Handling

Storage: Store at room temperature, protected from moisture and light.

Stability: Stable for 2-3 years under proper conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.