Classes
DEA Class; Rx
Common Brand Names; Isuprel
- Beta1/Beta2 Adrenergic Agonists
Description
Strong beta-1 & beta-2 effects resulting in relaxation of GI, bronchial, and uterine smooth muscle; may increase vasodilation of peripheral vasculature, and heart rate and contractility
Indications
Indicated for Adams-Stokes Attacks (Off-label), Cardiac Arrest (Off-label), Heart Block (Off-label), Bronchospasm During Anesthesia,Shock
Contraindications
Hypersensitivity, digitalis intoxication, angina pectoris, preexisting cardiac arrhythmias (particularly ventricular arrythmias that require inotropic treatment & tachyarrhythmias)
Adverse Effects
- Tachycardia
- Hypertension
- Dysrhythmias
- Angina
- Dizziness
- Nervousness
- Restlessness
- Hypokalemia
- MI size increased
- Syncope
- Confusion
- Headache
- Tremor
- Nausea
- Vomiting
- Weakness,
- Tremor
- Dyspnea
- Pulmonary edema
- Diaphoresis
- Blurred vision
Warnings
Use caution in patients with convulsive disorders, renal disease, CAD, coronary insufficiency, DM, HTN, hyperthyroidism, hyperresponsiveness to sympathomimetic amines, elderly
May cause thyroid storm in susceptible patients with hyperthyroidism
May transiently increase blood glucose levels
Pregnancy and Lactation
Prolonged experience with isoproterenol use in pregnant women over several decades, based on published literature, does not identify a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes; however, there are risks to the mother and fetus associated with isoproterenol use during labor or delivery
There is no information regarding presence of this drug in milk or effects of isoproterenol on breastfed infant or on milk production; due to its short half-life, isoproterenol exposure is expected to be very low in the breastfed infant
Maximum Dosage
Adults
Adams-Stokes Attacks, Cardiac Arrest, or Heart Block
IV bolus: 0.02-0.06 mg (1-3 mL of a 1:50,000 dilution), initially, THEN doses of 0.01-0.2 mg
IV infusion: 5 mcg/min (1.25 mL of a 1:250,000 dilution), initially, THEN doses of 2-20 mcg/min based on patient’s response
Shock
0.5-5 mcg/min (0.25-2.5 mL of a 1:250,000 dilution) IV infusion
Bronchospasm During Anesthesia
0.01-0.02 mg IV repeat PRN
Pediatric
Adams-Stokes Attacks (Off-label)
Initial: 0.1 mcg/kg/min IV infusion
Usual dose: 0.1-1 mcg/kg/min IV infusion
Cardiac Arrest (Off-label)
Initial: 0.1 mcg/kg/min IV infusion
Usual dose: 0.2 to 1 mcg/kg/min
Heart Block (Off-label)
Initial: 0.1 mcg/kg/min IV infusion
Usual dose: 0.3 to 1 mcg/kg/min IV infusion
Postoperative Cardiac Patients with Bradycardia
IV infusion: 0.029 mcg/kg/min
How supplied
Isoproterenol hydrochloride
injectable solution
- 0.2mg/mL
