Home Drug Guide Isoproterenol Hydrochloride

Drug Guide

Generic Name

Isoproterenol Hydrochloride

Brand Names Isuprel, Aerolone, Vapo-iso, Norisodrine Aerotrol

Classification

Therapeutic: Bronchodilator, Cardiac stimulant

Pharmacological: Beta-adrenergic agonist

FDA Approved Indications

Severe bradycardia or heart block with shock
Bronchospasm in acute asthma or bronchitis

Mechanism of Action

Isoproterenol is a non-selective beta-adrenergic agonist that stimulates both beta-1 and beta-2 receptors, leading to increased cardiac output and bronchodilation.

Dosage and Administration

Adult: 2-10 mcg/min IV infusion, titrated to response; inhalation dosing varies

Pediatric: 0.01-0.1 mcg/kg/min IV infusion, titrated as needed

Geriatric: Use with caution; start at lower doses due to increased sensitivity

Renal Impairment: Adjust doses cautiously; no specific guidelines, monitor closely

Hepatic Impairment: No specific dosage adjustments identified

Pharmacokinetics

Absorption: Administered parenterally; rapid onset

Distribution: Widely distributed in body tissues

Metabolism: Metabolized in the liver by conjugation

Excretion: Renally excreted as metabolites

Half Life: 2-10 minutes (IV infusion)

Contraindications

Tachyarrhythmias, ventricular fibrillation

Precautions

Use with caution in patients with ischemic heart disease, hypertension, or diabetes; may induce arrhythmias or angina

Adverse Reactions - Common

Tachycardia (Common)
Palpitations (Common)
Nausea (Common)

Adverse Reactions - Serious

Arrhythmias, including ventricular tachycardia or fibrillation (Serious)
Myocardial ischemia (Serious)

Drug-Drug Interactions

Beta-blockers decrease effectiveness, increase risk of adverse effects

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor cardiovascular status, blood pressure, EKG, and respiratory status during administration

Diagnoses:

Risk for cardiac arrhythmias
Ineffective tissue perfusion

Implementation: Administer IV infusion with infusion pump, monitor continuously, adjust dose as needed, inhalation routes for bronchospasm

Evaluation: Assess for improvements in cardiac output and respiratory status, monitor for adverse effects

Patient/Family Teaching

Follow prescription instructions carefully
Report chest pain, palpitations, or unusual symptoms immediately
Use as directed for inhalation for asthma or bronchospasm

Special Considerations

Black Box Warnings:

Use with caution due to risk of cardiovascular effects

Genetic Factors: None identified

Lab Test Interference: May alter serum glucose and potassium levels

Overdose Management

Signs/Symptoms: Severe tachycardia, arrhythmias, hypertension, chest pain, possible myocardial infarction

Treatment: Discontinue drug, provide supportive care, administer beta-blockers if appropriate, and manage arrhythmias as needed

Storage and Handling

Storage: Store at room temperature, protected from light and moisture

Stability: Stable for typical pharmacy storage durations