Home Drug Guide Isoproterenol Sulfate

Drug Guide

Generic Name

Isoproterenol Sulfate

Brand Names Norisodrine, Medihaler-iso

Classification

Therapeutic: Bronchodilator and cardiac stimulant

Pharmacological: Beta-adrenergic agonist

FDA Approved Indications

Treatment of bradycardia and heart block
Emergency treatment of bronchospasm in asthma or COPD

Mechanism of Action

Isoproterenol stimulates beta-adrenergic receptors, resulting in increased cardiac output, heart rate, and bronchodilation.

Dosage and Administration

Adult: Dose varies based on indication; for bronchospasm, typically 2-4 mcg/min IV infusion titrated to response. Cardiac indications require specific dosing directions.

Pediatric: Dosing depends on weight and indication; consult pediatric dosing guidelines.

Geriatric: Use with caution; start at lower doses due to increased risk of arrhythmias.

Renal Impairment: Adjust dose based on patient response; monitor closely.

Hepatic Impairment: No specific adjustments; monitor for enhanced responsiveness.

Pharmacokinetics

Absorption: By inhalation, IV, or IM; IV provides rapid onset.

Distribution: Widely distributed, crosses placental barrier.

Metabolism: Largely metabolized in the liver and tissues.

Excretion: Excreted mainly in urine as metabolites.

Half Life: About 2-5 minutes when administered IV.

Contraindications

Hypersensitivity to isoproterenol or other adrenergic agents.
Uncorrected thyrotoxicosis.
History of cardiac arrhythmias

Precautions

Use with caution in patients with ischemic heart disease, diabetes, or hypertension. Monitor for arrhythmias and hypertension.

Adverse Reactions - Common

Tachycardia (Common)
Palpitations (Common)
Headache (Less common)

Adverse Reactions - Serious

Arrhythmias (Serious)
myocardial infarction (Serious)
hypotension or hypertension (Serious)

Drug-Drug Interactions

Tricyclic antidepressants may enhance adrenergic effects, increasing the risk of arrhythmias.
Other sympathomimetic agents may increase cardiovascular side effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor heart rate, blood pressure, and ECG for arrhythmias. Assess respiratory status if used for bronchospasm.

Diagnoses:

Risk for arrhythmias
Ineffective airway clearance

Implementation: Administer IV infusion titrated to patient response. Use inhalation route as prescribed.

Evaluation: Evaluate cardiovascular response, respiratory status, and adverse effects.

Patient/Family Teaching

Report chest pain, palpitations, or irregular heartbeat immediately.
Avoid abrupt discontinuation.
Follow prescribed dosing and infusion guidelines.

Special Considerations

Black Box Warnings:

Use with caution in patients with ischemic heart disease due to risk of tachyarrhythmias and myocardial ischemia.

Genetic Factors: None specifically indicated.

Lab Test Interference: May interfere with cardiac enzyme tests; interpret with caution.

Overdose Management

Signs/Symptoms: Severe tachycardia, hypertension, arrhythmias, chest pain.

Treatment: Discontinue drug, provide supportive care, and treat symptoms as needed; may include beta-blockers in some cases under medical supervision.

Storage and Handling

Storage: Store at controlled room temperature, 20-25°C (68-77°F). Keep in original container.

Stability: Stable for the duration specified on the package; discard unused portion after the expiration date.