Isoproterenol

What is Isoproterenol?

• Isoproterenol (Isuprel) is a beta-adrenergic agonist is a medication used for the treatment of bradycardia (slow heart rate), heart block, and rarely for asthma.

Isoproterenol

What are the uses of this medicine?

Isoproterenol (Isuprel) is used:

• To improve hemodynamic status in patients in distributive shock and shock due to reduced cardiac output
• For bronchospasm occurring during anesthesia

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Isoproterenol

How does this medicine work?

• Isoproterenol is a potent nonselective beta-adrenergic agonist with very low affinity for alpha‑adrenergic receptors.
• Intravenous infusion of isoproterenol in man lowers peripheral vascular resistance, primarily in skeletal muscle but also in renal and mesenteric vascular beds.
• Diastolic pressure falls.
• Renal blood flow is decreased in normotensive subjects but is increased markedly in shock.
• Systolic blood pressure may remain unchanged or rise, although mean arterial pressure typically falls.
• Cardiac output is increased because of the positive inotropic and chronotropic effects of the drug in the face of diminished peripheral vascular resistance.
• Isoproterenol relaxes almost all varieties of smooth muscle when the tone is high, but this action is most pronounced on bronchial and gastrointestinal smooth muscle.
• It prevents or relieves bronchoconstriction, but tolerance to this effect develops with overuse of the drug.

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• tachycardia
• ventricular arrhythmias
• angina pectoris

What drug interactions can this medicine cause?

• Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Be sure to mention any of the following:

• epinephrine
• tricyclic antidepressants
• monoamine oxidase inhibitors
• levothyroxine sodium
• certain antihistamines, notably chlorpheniramine, tripelennamine, and diphenhydramine
• beta-adrenergic blocking drugs, such as propranolol

Is this medicine FDA approved?

• It was first approved in the US in 1947.

How should this medicine be used?

Recommended dosage: Recommended initial dosage:

• Shock: 0.5 mcg to 5 mcg per minute as an intravenous infusion.
• Bronchospasm: 10 mcg to 20 mcg intravenous injection.

Administration:

• Isoproterenol comes as sterile solution is nonpyrogenic and can be administered by the intravenous route.
• Inspect visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
• Do not use if the injection is pinkish or darker than slightly yellow or contains a precipitate.
• Discard any unused portion.
• Diluted solution should be used immediately.
• Unused material should be discarded.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Injection: 0.2 mg/mL and 1 mg/5 mL (0.2 mg/mL) single dose vial

This medicine is available in fallowing brand namesː

• Isuprel

What side effects can this medication cause?

The most common side effects of this medicine include:

• Nervousness
• headache
• dizziness
• visual blurring
• Tachycardia
• tachyarrhythmias
• palpitations
• angina
• ventricular arrhythmias
• Adams-Stokes attacks
• pulmonary edema
• Dyspnea
• Flushing of the skin
• sweating
• mild tremors
• pallor
• nausea

What special precautions should I follow?

• Isoproterenol may induce cardiac arrhythmias and myocardial ischemia in patients, especially patients with coronary artery disease, or cardiomyopathy.
• Isuprel contains sodium metabisulfite, which may cause mild to severe allergic reactions including anaphylaxis or asthmatic episodes, particularly in patients with a history of allergies.
• Isoproterenol hydrochloride injection should generally be started at the lowest recommended dose. This may be gradually increased if necessary while carefully monitoring the patient.

What to do in case of emergency/overdose?

Symptoms of overdose may include: Tachycardia or other arrhythmias, palpitations, angina, hypotension, or hypertension

Management of overdosage:

• In case of overdosage, reduce the rate of administration or discontinue isoproterenol hydrochloride injection until patient’s condition stabilizes.
• Monitor blood pressure, pulse, respiration, and EKG.
• It is not known whether isoproterenol hydrochloride is dialyzable.

Can this medicine be used in pregnancy?

• Prolonged experience with isoproterenol use in pregnant women over several decades, based on published literature, do 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.
• Avoid isoproterenol during the second stage of labor.
• Avoid isoproterenol in obstetrics when maternal blood pressure exceeds 130/80 mmHg.

Can this medicine be used in children?

• Safety and efficacy of isoproterenol in pediatric patients have not been established.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• ISOPROTERENOL HYDROCHLORIDE

Inactive ingredients:

• EDETATE DISODIUM
• SODIUM CHLORIDE
• TRISODIUM CITRATE DIHYDRATE
• ANHYDROUS CITRIC ACID
• WATER
• HYDROCHLORIC ACID
• SODIUM HYDROXIDE

Who manufactures and distributes this medicine?

Distributed by:

• Bausch Health US, LLC
• Bridgewater, NJ USA
• Isuprel is a registered trademark of Hospira, Inc. used under license.

What should I know about storage and disposal of this medication?

• Store at 20º to 25ºC (68º to 77ºF).
• Do not use if the injection is pinkish or darker than slightly yellow or contains a precipitate.
• Discard unused portion.
• Protect from light. Keep in opaque container until used.

• Dailymed label info on Isoproterenol
• FDA Isoproterenol

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