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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS, INHALANTS › Adrenergics in combination with corticosteroids or other drugs, excl. anticholinergics
isoprenaline and other drugs for obstructive airway diseases
R03AK02
Forms & Strengths
- Inhalation aerosol/spray
- Solution for inhalation
- Intravenous injection/infusion
- Subcutaneous/intramuscular injection
Adult Dosing
- Bronchospasm (Inhalation): 1-2 puffs (as metered aerosol) as needed, not to exceed every 3-4 hours.
- Bronchospasm (IV infusion): 0.01-0.05 mcg/kg/min titrated to heart rate and clinical response.
- Heart block/Bradycardia (IV/IM/SubQ): 0.02-0.2 mg initially, then 0.01-0.2 mg maintenance.
Pediatric Dosing
- Bronchospasm (Inhalation): 1 inhalation as needed, maximum 3-4 times daily.
- Bradycardia/Heart block (IV): 0.01 mcg/kg/min titrated up to 0.05-0.1 mcg/kg/min.
Indications
- Treatment of bronchospasm associated with acute or chronic asthma, bronchitis, and emphysema
- Management of transient heart block and severe bradycardia unresponsive to atropine
Mechanism of Action
- Non-selective beta-1 and beta-2 adrenergic receptor agonist
- Stimulates beta-2 receptors in bronchial smooth muscle, causing relaxation and bronchodilation
- Stimulates beta-1 receptors in the heart, increasing heart rate, conduction velocity, and myocardial contractility
Contraindications
- Hypersensitivity to isoprenaline or sympathomimetics
- Tachyarrhythmias or tachycardia caused by digitalis toxicity
- Angina pectoris or pre-existing ischemic heart disease (for systemic use due to increased oxygen demand)
Adverse Reactions
- Tachycardia, palpitations, and cardiac arrhythmias
- Tremors, nervousness, and anxiety
- Headache and dizziness
- Flushing and sweating
- Paradoxical bronchospasm with excessive use
Drug Interactions
- Beta-blockers antagonize the bronchodilatory and cardiac effects of isoprenaline
- Halogenated hydrocarbon anesthetics increase myocardial irritability and risk of serious arrhythmias
- Tricyclic antidepressants and MAOIs potentiate vascular effects and risk of severe cardiovascular toxicity
- Other sympathomimetic agents lead to additive cardiovascular toxicity
Curated Content: Needs Vetting Before Put to Clinical Use