Home Drug Guide Metaproterenol Sulfate

Drug Guide

Generic Name

Metaproterenol Sulfate

Brand Names Alupent, Prometa

Classification

Therapeutic: Bronchodilator

Pharmacological: Beta-adrenergic agonist

FDA Approved Indications

  • Asthma
  • Bronchospasm associated with COPD

Mechanism of Action

Metaproterenol is a non-selective beta-adrenergic receptor agonist that stimulates beta-2 receptors in bronchial smooth muscle, leading to relaxation and bronchodilation.

Dosage and Administration

Adult: Typically, inhalation of 0.2-0.3 mL of a 0.2% solution 3-4 times daily as needed.

Pediatric: Dosing varies by age and weight; usually 0.2 mL of 0.2% solution 2-4 times daily. Specific pediatric dosing should follow physician guidance.

Geriatric: Use with caution; start at the lower end of dosing range due to potential increased sensitivity.

Renal Impairment: Use with caution; no specific adjustment established.

Hepatic Impairment: Use with caution; monitor for exaggerated response.

Pharmacokinetics

Absorption: Rapid via inhalation

Distribution: Widely distributed in tissues, with limited studies on plasma protein binding.

Metabolism: Primarily hepatic metabolism; undergoes conjugation.

Excretion: Renal elimination of metabolites.

Half Life: Approximately 3-6 hours.

Contraindications

  • Hypersensitivity to metaproterenol or related compounds.
  • Tachyarrhythmias including tachycardia, or severe cardiac disease.

Precautions

  • Use cautiously in patients with hypertension, diabetes, hyperthyroidism, or tremors; monitor for paradoxical bronchospasm. Not recommended for use in acute heart attack.

Adverse Reactions - Common

  • Tremor (frequent)
  • Nervousness or anxiety (common)
  • Palpitations (common)
  • Headache (common)

Adverse Reactions - Serious

  • Tachycardia (rare)
  • Cardiac arrhythmias (rare)
  • Paradoxical bronchospasm (rare)

Drug-Drug Interactions

  • Might have additive effects with other sympathomimetics or stimulants.
  • Beta-blockers may diminish the effectiveness.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, lung sounds, and patient response.

Diagnoses:

  • Ineffective airway clearance
  • Risk for decreased cardiac output

Implementation: Administer via inhalation as prescribed, observe for tolerance or adverse effects.

Evaluation: Assess improvement in airflow, reduction in wheezing, and patient comfort.

Patient/Family Teaching

  • Use inhaler correctly; teach proper inhalation technique.
  • Report increased or unusual shortness of breath, chest pain, or adverse reactions.
  • Avoid extraneous stimuli and triggers.

Special Considerations

Black Box Warnings:

  • Potential for paradoxical bronchospasm; discontinue if occurs.

Genetic Factors: No specific genetic considerations documented.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Severe tachycardia, hypertension, hypokalemia, tremors.

Treatment: Discontinue medication, support airway and respiration, manage cardiac symptoms with beta-blockers if appropriate, and provide symptomatic treatment.

Storage and Handling

Storage: Store at room temperature, away from heat and moisture.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.