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|Isoproterenol |
Drugs search, click the first letter of a drug name: | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 1 | 2 | 3 | 4 | 5 | 6 | 8 | 9 Home IsoproterenolPronouncation: (eye-so-pro-TER-uh-nahl)Class: Vasopressor used in shock Isoproterenol Hydrochloride Trade Names: Trade Names: Trade Names: Mechanism of ActionPharmacologyProduces bronchodilation by relaxing bronchial smooth muscle through beta-2 receptor stimulation; increases heart rate and myocardial contractility by stimulating cardiac beta-1 receptors, which increases cardiac output. PharmacokineticsOnsetWithin 5 minutes. PeakFive to 15 minutes. DurationLess than 3 hours. Indications and UsageManagement of bronchospasm during anesthesia; adjunctive treatment for shock. ContraindicationsCardiac arrhythmias associated with tachycardia; tachycardia or heart block caused by digitalis intoxication; angina; ventricular arrhythmias requiring inotropic therapy. Dosage and AdministrationBronchospasm during anesthesiaAdults IV 0.01 to 0.02 mg. Repeat as necessary. Shock and hypoperfusionAdults IV 0.5 mcg to 5 mcg/min. Rates over 30 mcg/min have been used in advanced stages of shock. Heart block, Adams-Stokes attacks, and cardiac arrestAdults Bolus IV 0.02 mg to 0.06 mg initial dose with subsequent dose range of 0.01 mg to 0.2 mg; IV infusion 5mcg/min initial dose; IM 0.2 mg initial dose with a subsequent dose rang of 0.02 mg to 1 mg; SC 0.2 mg initial dose of 0.2 mg with subsequent dose range of 0.15 mg to 0.2 mg; Intracardiac 0.02 mg initial dose. Subsequent dosage and administration method depend on ventricular rate and rapidity with which cardiac pacemaker can take over when drug is withdrawn. General AdviceIV injectionDilute 1 mL of 1:5000 solution to 10 mL with 5% Sodium Chloride or Dextrose Injection to achieve 1:50,000 solution. IV infusionDilute 10 mL 1:5000 solution in 500 mL 5% Dextrose to produce 1:250,000 solution. Use microdrip or continuous infusion pump to prevent sudden influx of large amount of drug. Metered dose inhalerShake container thoroughly before use. Storage/StabilityStore in tight, light-resistant container at room temperature. Drug InteractionsCardiac glycosidesArrhythmias may result with coadministration. General anesthetics (eg, halothane, cyclopropane)Arrhythmias may result with coadministration. Ergot alkaloidsCoadministration may result in additive peripheral vasoconstriction. Laboratory Test InteractionsBilirubin may be falsely elevated if measured by sequential multiple analyzer. Urinary epinephrine values may be elevated. Adverse ReactionsCardiovascularPalpitations; tachycardia; blood pressure changes; arrhythmias; Adams-Stokes attacks; cardiac arrest. CNSTremor; dizziness; nervousness; drowsiness; headache; insomnia. GINausea; GI distress. RespiratoryCough; throat irritation; bronchitis; sputum increase; pulmonary edema. MiscellaneousParotid gland swelling with prolonged use; saliva discoloration; sweating; skin flushing. PrecautionsPregnancyCategory C . LactationUndetermined. ChildrenSafety and efficacy have not been established. ElderlyLower doses may be required. Labor and DeliveryMay inhibit uterine contractions and delay preterm labor. Cardiogenic shockIsoproterenol HCl injection, by increasing myocardial oxygen requirements while decreasing effective coronary perfusion, may have a deterious effect on the injured or failing heart. Most experts discourage its use as the initial agent in treating cardiogenic shock following myocardial infarction. Cardiovascular disordersToxic symptoms in patients with cardiovascular disorders may occur. Doses sufficient to increase the heart rate more than 130 bpm may induce ventricular arrhythmias. Use with caution in patients with coronary artery disease, coronary insufficiency, diabetes, or hyperthyroidism, and in patients sensitive to sympathomimetic amines. HypovolemiaAdequate filling of the intravascular compartment by suitable volume expanders is of primary importance in most cases of shock and should precede the administration of vasoactive drugs. Refractory asthmatic childrenIV infusions of isoproterenol have caused clinical deterioration, myocardial necrosis, congestive heart failure, and death. OverdosageSymptomsTremor, palpitations, angina, arrhythmias, tachycardia, elevated or decreased blood pressure, seizures, nervousness, headache, dry mouth, nausea, dizziness, fatigue, malaise, insomnia. Patient Information
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