Isoproterenol Brand Name– Isuprel
What is Isoproterenol
Isoproterenol is a parenteral non-selective beta-adrenergic agonist indicated for mild or transient episodes of heart block that do not require electric shock or pacemaker therapy, serious episodes of heart block and Adams-Stokes attacks (except when caused by ventricular tachycardia or fibrillation), cardiac arrest until electric shock or pacemaker therapy is available, bronchospasm occurring during anesthesia, and as an adjunct to fluid and electrolyte replacement therapy and other medications and procedures in the treatment of hypovolemic and septic shock, low cardiac output states, congestive heart failure, and cardiogenic shock.
It is a synthetic sympathomimetic amine structurally similar to epinephrine. Isoproterenol has very low affinity for alpha-adrenergic receptors.
Guidelines do not recommend isoproterenol for use during cardiac arrest.
Although not a first line agent, isoproterenol may be used for bradyarrhythmias unresponsive to or inappropriate for treatment with atropine or while awaiting the availability of a pacemaker
In patients with sinus node dysfunction or second- or third-degree atrioventricular block associated with symptoms of hemodynamic compromise who are at a low likelihood of coronary ischemia, isoproterenol may be considered to increase heart rate, improve atrioventricular conduction, increase ventricular rate, and improve symptoms.
Indications
- acute bronchospasm
- Adams-Stokes syndrome
- AV block
- bradycardia
- cardiac arrest
- cardiogenic shock
- cardiopulmonary resuscitation
- heart failure
- neurocardiogenic syncope diagnosis
- septic shock
For the treatment of symptomatic bradycardia† unresponsive to atropine and/or external pacing
Side Effects
- angina
- arrhythmia exacerbation
- blurred vision
- bronchospasm
- cardiac arrest
- diaphoresis
- dizziness
- dyspnea
- flushing
- headache
- heart failure
- hypotension
- myocardial infarction
- nausea
- pallor
- palpitations
- sinus tachycardia
- tolerance
- tremor
- ventricular fibrillation
- ventricular tachycardia
- vertigo
- weakness
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- angina
- atrial fibrillation
- atrial flutter
- breast-feeding
- cardiac disease
- coronary artery disease
- diabetes mellitus
- digitalis toxicity-induced AV block
- geriatric
- hypertension
- hyperthyroidism
- labor
- pheochromocytoma
- pregnancy
- tachycardia
- thyroid disease
- ventricular fibrillation
- ventricular tachycardia
Interactions
- Acarbose
- Acebutolol
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Aclidinium; Formoterol
- Albiglutide
- Albuterol
- Albuterol; Ipratropium
- Alogliptin; Pioglitazone
- Alpha-blockers
- Alpha-glucosidase Inhibitors
- Ambrisentan
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Amoxapine
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Arformoterol
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Atenolol
- Atenolol; Chlorthalidone
- Azelastine; Fluticasone
- Beclomethasone
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bendroflumethiazide; Nadolol
- Beta-blockers
- Betamethasone
- Betaxolol
- Bethanechol
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Bosentan
- Bretylium
- Brimonidine; Timolol
- Budesonide
- Budesonide; Formoterol
- Caffeine
- Caffeine; Ergotamine
- Calcium-channel blockers
- Canagliflozin
- Canagliflozin; Metformin
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Cardiac glycosides
- Carteolol
- Carvedilol
- Chlorthalidone; Clonidine
- Ciclesonide
- Clonidine
- Cocaine
- Colchicine
- Colchicine; Probenecid
- COMT inhibitors
- Corticosteroids
- Cortisone
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Deflazacort
- Dexamethasone
- Digitoxin
- Digoxin
- Dihydroergotamine
- Dipeptidyl Peptidase-4 Inhibitors
- Dorzolamide; Timolol
- Doxazosin
- Dronabinol
- Dulaglutide
- Dyphylline
- Dyphylline; Guaifenesin
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Entacapone
- Eplerenone
- Epoprostenol
- Ergoloid Mesylates
- Ergonovine
- Ergotamine
- Ertugliflozin
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Esmolol
- Exenatide
- Fludrocortisone
- Flunisolide
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol
- Formoterol; Mometasone
- Ginger, Zingiber officinale
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glycopyrrolate; Formoterol
- Green Tea
- Guanabenz
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrocortisone
- Iloprost
- Incretin Mimetics
- Indacaterol
- Indacaterol; Glycopyrrolate
- Indapamide
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Iobenguane I 131
- Isocarboxazid
- Ketamine
- Labetalol
- Levalbuterol
- Levobetaxolol
- Levobunolol
- Levodopa
- Levothyroxine
- Levothyroxine; Liothyronine (Porcine)
- Levothyroxine; Liothyronine (Synthetic)
- Linezolid
- Liothyronine
- Liraglutide
- Lixisenatide
- Loop diuretics
- Macitentan
- Maprotiline
- Mecamylamine
- Meglitinides
- Metaproterenol
- Metformin; Pioglitazone
- Metformin; Rosiglitazone
- Methohexital
- Methyldopa
- Methylergonovine
- Methylprednisolone
- Methysergide
- Metoprolol
- Miglitol
- Mometasone
- Monoamine oxidase inhibitors
- Nabilone
- Nadolol
- Nebivolol
- Nebivolol; Valsartan
- Nesiritide, BNP
- Nicotine
- Nitrates
- Ozanimod
- Penbutolol
- Phenelzine
- Phenoxybenzamine
- Phentolamine
- Pindolol
- Pioglitazone
- Pirbuterol
- Potassium-sparing diuretics
- Pramlintide
- Prazosin
- Prednisolone
- Prednisone
- Procarbazine
- Propofol
- Propranolol
- Rasagiline
- Reserpine
- Riociguat
- Rosiglitazone
- Safinamide
- Salmeterol
- Selegiline
- Selexipag
- Semaglutide
- SGLT2 Inhibitors
- Sibutramine
- Sotalol
- Spironolactone
- St. John’s Wort, Hypericum perforatum
- Sulfonylureas
- Terazosin
- Terbutaline
- Theophylline, Aminophylline
- Thiazide diuretics
- Thiazolidinediones
- Thiopental
- Thyroid hormones
- Timolol
- Tolcapone
- Tranylcypromine
- Treprostinil
- Triamcinolone
- Triamterene
- Umeclidinium; Vilanterol
- Vasodilators
- Yohimbine
