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isoprenaline

R03CB01

Forms & Strengths

Solution for injection: 0.2 mg/mL (1 mL ampoules)
Inhalation solution: 1:200 and 1:400

Adult Dosing

Bradydysrhythmias / Heart Block: IV infusion of 2 to 20 mcg/min titrated to response
Emergency AV block: IV bolus of 0.02 to 0.06 mg (1-3 mL of 1:50,000 dilution) initially, then 0.01 to 0.2 mg
Bronchospasm: Inhalation of 1 to 2 inhalations of a 1:200 solution

Pediatric Dosing

Bradydysrhythmias / Heart Block: IV infusion starting at 0.1 mcg/kg/min, titrated up to 1 mcg/kg/min
Bronchospasm: Inhalation of 1 inhalation of 1:200 or 1:400 solution, repeated not more often than every 4 hours

Indications

Management of bronchospasm during anesthesia
Adjunctive treatment of Stokes-Adams attacks and severe bradycardia unresponsive to atropine
Hemodynamic support in refractory torsades de pointes

Mechanism of Action

Non-selective beta-1 and beta-2 adrenergic receptor agonist
Stimulation of beta-1 receptors increases heart rate, conduction velocity, and myocardial contractility
Stimulation of beta-2 receptors causes relaxation of bronchial, GI, and vascular smooth muscle

Contraindications

Tachyarrhythmias or digitalis-induced tachycardia
Angina pectoris
Known hypersensitivity to isoprenaline or sympathomimetics

Adverse Reactions

Tachycardia, palpitations, and anginal pain
Arrhythmias, ventricular ectopics, and cardiac arrest
Tremor, nervousness, headache, and dizziness
Flushing, diaphoresis, and hypertension or hypotension

Drug Interactions

Other sympathomimetic agents increase risk of severe cardiovascular toxicity
Beta-blockers antagonize the therapeutic effects of isoprenaline
General anesthetics (especially halogenated hydrocarbons) sensitize the myocardium to arrhythmias
MAO inhibitors and tricyclic antidepressants potentiate vascular effects

Curated Content: Needs Vetting Before Put to Clinical Use