Drug Guide
Isosulfan Blue
Classification
Therapeutic: Vascular visualization agent
Pharmacological: Vital dye
FDA Approved Indications
- Lymphatic mapping in breast cancer and melanoma surgeries
Mechanism of Action
Isosulfan Blue selectively binds to serum proteins and is taken up by the lymphatic system, allowing visualization of lymphatic vessels and nodes during surgery.
Dosage and Administration
Adult: Typically, 1-2 mL of Isosulfan Blue is injected subdermally near the tumor or lesion site.
Pediatric: Use with caution; dosing should be based on body weight and clinical judgment.
Geriatric: Adjustments based on renal function and overall health status.
Renal Impairment: Use cautiously; impaired renal function may affect clearance.
Hepatic Impairment: No specific adjustments known, but caution advised.
Pharmacokinetics
Absorption: Rapidly absorbed from injection site.
Distribution: Binds to serum proteins; distributed to lymphatic tissues.
Metabolism: Metabolized minimally; primary pathway unclear.
Excretion: Excreted mainly via urine.
Half Life: Approximately 15-20 minutes in circulation.
Contraindications
- Known hypersensitivity to Isosulfan Blue or other dye components.
Precautions
- Use with caution in patients with a history of allergy to dyes or sulfites. Be aware of potential anaphylactic reactions. Prepare for emergency management of allergic responses.
Adverse Reactions - Common
- Allergic reactions such as rash, pruritus, or mild edema. (Uncommon)
- Transient local swelling or discoloration. (Common)
Adverse Reactions - Serious
- Anaphylaxis, including airway constriction, hypotension, shock. (Rare)
- Tissue necrosis if extravasation occurs. (Very rare)
Drug-Drug Interactions
- Potential additive risk of allergic reactions with other dyes or intravenous agents.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for signs of allergic reactions during and after administration.
Diagnoses:
- Risk for allergic reaction related to dye administration.
Implementation: Administer as per dosing guidelines; have emergency equipment ready.
Evaluation: Observe for adverse reactions or allergic responses post-injection.
Patient/Family Teaching
- Inform patient of possible allergic reactions.
- Advise immediately reporting any itching, swelling, difficulty breathing after procedure.
Special Considerations
Black Box Warnings:
- Potential for severe allergic reactions including anaphylaxis.
Genetic Factors: Not applicable.
Lab Test Interference: May cause temporary discoloration of urine and tissues, potentially affecting some diagnostic assessments.
Overdose Management
Signs/Symptoms: Excessive allergic reactions, tissue necrosis, or systemic toxicity.
Treatment: Discontinue use, provide supportive care, antihistamines, corticosteroids, and emergency interventions as needed.
Storage and Handling
Storage: Store in a cool, dry place, protected from light.
Stability: Stable until expiration date if stored properly.