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Isoproterenol

    Brands

    DEA Class;  Rx

    Common Brand Names; Isuprel

    • Beta1/Beta2 Adrenergic Agonists

    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

    Indicated for Adams-Stokes Attacks (Off-label), Cardiac Arrest (Off-label), Heart Block (Off-label), Bronchospasm During Anesthesia,Shock

    Hypersensitivity, digitalis intoxication, angina pectoris, preexisting cardiac arrhythmias (particularly ventricular arrythmias that require inotropic treatment & tachyarrhythmias)

    • 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

    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

    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

    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

    Isoproterenol hydrochloride

    injectable solution

    • 0.2mg/mL