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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › CARDIAC STIMULANTS EXCL. CARDIAC GLYCOSIDES › Adrenergic and dopaminergic agents
isoprenaline
C01CA02
Forms & Strengths
- Injection: 0.2 mg/mL (1 mL ampoules)
Adult Dosing
- AV block / Bradycardia: IV infusion 2-20 mcg/min titrated to heart rate and rhythm
- Cardiac arrest: IV bolus 0.02-0.06 mg (1-3 mL of diluted solution), followed by maintenance infusion
Pediatric Dosing
- Bradycardia / Heart block: IV infusion 0.05-2 mcg/kg/min titrated to response
Indications
- Management of occasional episodes of severe bradycardia or heart-block not responsive to atropine
- Control of bronchospasm during anesthesia
- Adjuvant treatment of hypovolemic and septic shock
Mechanism of Action
- Non-selective beta-1 and beta-2 adrenergic agonist with potent inotropic and chronotropic effects
- Relaxes bronchial, gastrointestinal, and vascular smooth muscle
- Produces marked increase in cardiac output and decrease in peripheral vascular resistance
Contraindications
- Tachyarrhythmias or digitalis-induced tachycardia
- Angina pectoris
- Known hypersensitivity to isoprenaline or sympathomimetics
Adverse Reactions
- Tachycardia, palpitations, and anginal pain
- Arrhythmias, including ventricular arrhythmias and ventricular fibrillation
- Headache, nervousness, and tremor
- Flushing and sweating
Drug Interactions
- Halogenated hydrocarbon anesthetics: sensitize myocardium to catecholamines, increasing risk of serious arrhythmias
- Beta-blockers: antagonize therapeutic effects of isoprenaline
- Monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants: potentiate cardiovascular effects leading to severe hypertension or arrhythmias
Curated Content: Needs Vetting Before Put to Clinical Use