isoproterenol

Contraindicated in:

Hypersensitivity to adrenergic amines or bisulfites.

Use Cautiously in:

Cardiovascular disease (including hypertension and coronary artery disease);
Hyperthyroidism;
Diabetes;
Glaucoma;
Pedi: Safety and effectiveness not established in children;
Geri: Older adults are more susceptible to adverse reactions; may require dose ↓.

Adv. Reactions/Side Effects ⬆ ⬇

CV: angina, hypertension, tachycardia, ARRHYTHMIAS

Endo: hyperglycemia

GI: nausea, vomiting, xerostomia

Neuro: nervousness, restlessness, tremor, headache, insomnia

Misc: pink/red discoloration of saliva

Interactions ⬆ ⬇

Drug-drug:

Concurrent use with other adrenergic agents (sympathomimetics) will have additive adrenergic side effects.
Use with MAO inhibitors may lead to hypertensive crisis.
May increase theophylline elimination.
Beta blockers may negate therapeutic effect.

Availability ⬆ ⬇

(Generic available)

Solution for injection: 200 mcg (0.2 mg)/mL

Route/Dosage ⬆ ⬇

IV (Adults ): Bradycardia or AV block: 1–20 mcg/min continuous infusion; Bronchospasm during anesthesia: 10–20 mcg, repeated as needed.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Results in the accumulation of cyclic adenosine monophosphate (cAMP) at beta-adrenergic receptors.
Produces bronchodilation.
Produces positive inotropic and chronotropic effects.

Therapeutic effects:

Bronchodilation.
Increased heart rate.

Classifications ⬆ ⬇

Therapeutic Classification: antiarrhythmics, bronchodilators

Pharmacologic Classification: adrenergics

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Metabolism occurs in the lung, liver, and other tissues; 50% excreted unchanged by the kidneys.

Half-Life: 2.5–5 min.

Time/Action Profile ⬆ ⬇

(bronchodilation)

ROUTE	ONSET	PEAK	DURATION
IV	immediate	unknown	<1 hr

Patient/Family Teaching ⬆ ⬇

Explain purpose of isoproterenol to patient.
Advise patient to consult health care professional before taking any OTC medications or alcoholic beverages concurrently with this therapy. Caution patient also to avoid smoking and other respiratory irritants.
Instruct patient to contact health care professional immediately if shortness of breath is not relieved by medication or is accompanied by diaphoresis, dizziness, palpitations, or chest pain.
Rep: Isoproterenol usually inhibits spontaneous or oxytocin-induced contractions of the pregnant human uterus and may delay the second stage of labor. Avoid isoproterenol during the second stage of labor. Avoid isoproterenol in obstetrics when maternal blood pressure exceeds 130/80 mmHg.

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Indications ⬇

Contraind./Precautions ⬆ ⬇