isoproterenol hydrochloride


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isoproterenol hydrochloride

Isuprel

Pharmacologic class: Sympathomimetic, beta1-adrenergic and beta2-adrenergic agonist

Therapeutic class: Vasopressor, bronchodilator, antiasthmatic

Pregnancy risk category C

Action

Acts on beta2-adrenergic receptors, causing relaxation of bronchial smooth muscle; acts on beta1-adrenergic receptors in heart, causing positive inotropic and chronotropic effects and increasing cardiac output. Also lowers peripheral vascular resistance in skeletal muscle and inhibits antigen-induced histamine release.

Availability

Injection: 20 mcg/ml, 200 mcg/ml

Indications and dosages

Shock

Adults and children: 0.5 to 5 mcg/minute by continuous I.V. infusion

Heart block; ventricular arrhythmias

Adults: Initially, 0.02 to 0.06 mg I.V., then 0.01 to 0.2 mg I.V. or 5 mcg/minute I.V. Or initially, 0.2 mg I.M., then 0.02 to 1 mg I.M., depending on response. Or initially, 0.2 mg subcutaneously, then 0.15 to 0.2 mg subcutaneously, depending on response.

Bronchospasm during anesthesia

Adults: 0.01 to 0.02 mg I.V., repeated when necessary

Contraindications

• Angina pectoris
• Angle-closure glaucoma
• Tachyarrhythmias
• Tachycardia or heart block caused by digitalis intoxication
• Ventricular arrhythmias that warrant inotropic therapy
• Labor, delivery, breastfeeding

Precautions

Use cautiously in:
• renal impairment, unstable vasomotor disorders, hypertension, coronary insufficiency, chronic obstructive pulmonary disease, diabetes mellitus, hyperthyroidism
• history of cerebrovascular accident or seizures
• elderly patients.

Administration

• Give each 0.02-mg I.V. dose by direct injection over 1 minute, or by I.V. infusion, as ordered. Always use continuous infusion pump to deliver infusion.

Adverse reactions

CNS: tremors, anxiety, insomnia, headache, dizziness, asthenia, nervousness

CV: palpitations, tachycardia, angina, rapid blood pressure changes, arrhythmias, cardiac arrest, Stokes-Adams attacks

EENT: pharyngitis, visual blurring

GI: nausea, vomiting, heartburn

Metabolic: hyperglycemia

Respiratory: bronchitis, dyspnea, increased sputum, pulmonary edema, bronchospasm

Skin: diaphoresis

Other: parotid gland swelling (with prolonged use), pallor

Interactions

Drug-drug.Cyclopropane, epinephrine, halogenated general anesthetics: increased risk of arrhythmias

Propranolol, other beta-adrenergic blockers: antagonism of bronchodilating effects

Drug-diagnostic tests.Glucose: increased level

Patient monitoring

• During I.V. administration, monitor ECG and vital signs carefully.
• Assess patient's response to drug and adjust I.V. infusion rate accordingly.
• Closely monitor arterial blood gas values, urine output, and central venous pressure.

Stay alert for rebound bronchospasm.

Patient teaching

• Assure patient that he'll be monitored closely.

isoproterenol hydrochloride

(ī′sō-prə-târ′ə-nŏl′ -nôl)
n.
A sympathomimetic drug that causes bronchodilation, used parenterally to treat asthma.

isoproterenol hydrochloride

[ī′sōprəter′ənol]
a beta-adrenergic stimulant.
indications It is used as a bronchodilator and as a cardiac stimulant.
contraindications Cardiac arrhythmia or known hypersensitivity to this drug prohibits its use.
adverse effects Among the more serious adverse effects are arrhythmias, tachycardia, hypotension, and intensification of angina.

isoproterenol hydrochloride

(ī″sō-prō″tĕr′ĭ-nŏl″)
A sympathomimetic amine used to relieve bronchoconstriction in asthma and also as a cardiac stimulant in heart block.

CAUTION!

Overdosage administered by inhalation can be fatal.