WHO Model Prescribing Information: Drugs Used in Anaesthesia
(1989; 60 pages) [French] Ver el documento en el formato PDF
Índice de contenido
Ver el documentoPreface
Ver el documentoIntroduction
Abrir esta carpeta y ver su contenidoPremedication
Abrir esta carpeta y ver su contenidoGeneral anaesthetics and oxygen
Abrir esta carpeta y ver su contenidoLocal anaesthetics
Abrir esta carpeta y ver su contenidoNon-opioid analgesics
Abrir esta carpeta y ver su contenidoOpioid analgesics and antagonists
Cerrar esta carpetaMuscle relaxants and cholinesterase inhibitors
Ver el documentoGallamine
Ver el documentoSuxamethonium
Ver el documentoNeostigmine
Abrir esta carpeta y ver su contenidoBlood substitutes
Abrir esta carpeta y ver su contenidoSolutions for correcting water and electrolyte imbalance
Abrir esta carpeta y ver su contenidoAntacid for use in obstetric practice
Ver el documentoAnaesthesia at the District Hospital
Ver el documentoSelected WHO publications of related interest
Ver el documentoBack cover
 

Gallamine

Group: non-depolarizing muscle relaxant
Injection: 40 mg (triethiodide)/ml in 2-ml ampoule

General information

Gallamine is a synthetic non-depolarizing neuromuscular blocking agent. Its effect becomes apparent within 2 minutes of intravenous administration and persists for up to 40 minutes. It is excreted in the urine largely unchanged.

Clinical information

Uses

To produce relaxation of skeletal muscle during surgery.

Dosage and administration

Muscle relaxants should be administered only after induction of anaesthesia and when a secure airway has been established. The dosage must be adjusted according to the response. As a guide:

Adults: 1-1.5 mg/kg i.v. initially, then 0.5-1 mg/kg as required at about 40-minute intervals.

Children: 1.5 mg/kg initially, then 0.5 mg/kg as required.

Infants of less than 1 month: 250-750 micrograms/kg initially, then 100-500 micrograms/kg as required.

Contraindications

• Known hypersensitivity to gallamine.
• Myasthenia gravis.
• Shock and impaired renal function.
• Cardiac disease predisposing to dysrhythmias.

Precautions

Gallamine should be used, whenever possible, by an experienced specialist anaesthetist. Facilities for endotracheal intubation and mechanically assisted ventilation should be immediately to hand and ready for use.

Gallamine should not be administered before evidence of recovery from the effect of any suxamethonium given previously.

Use in pregnancy

Gallamine should be used in pre-term pregnancy only when the need outweighs any possible risk to the fetus. Its use is best avoided in obstetric practice since gallamine crosses the placenta.

Adverse effects

Gallamine may produce vagolytic tachycardia. Anaphylactoid reactions rarely occur.

Drug interactions

The effect of gallamine may be appreciably prolonged by many other drugs including streptomycin, neomycin, polymyxin B, kanamycin, quinidine, propranolol and procainamide.

Ether and halothane potentiate the action of gallamine and other non-depolarizing muscle relaxants. The dose of gallamine should be reduced by 40% when used with ether, and by 20% when used with halothane.

Used concomitantly with gallamine, potassium-depleting agents, particularly thiazide diuretics and furosemide, may cause prolonged neuromuscular blockade.

Overdosage

Ventilation must be mechanically assisted until spontaneous respiration is fully re-established and the patient must be closely monitored until all risk of recrudescence of muscular paralysis has passed.

Muscular paralysis can generally be rapidly reversed by neostigmine after atropine has been administered to prevent excessive autonomic stimulation. This reversal occurs more rapidly if some return of muscle tone is evident before neostigmine is given.

Storage

Gallamine injection should be kept protected from light, and should not be allowed to freeze.

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