Isoproterenol
Mechanism :
Stimulates beta1- and beta2-receptors resulting in relaxation of bronchial, GI, and uterine smooth muscle, increased heart rate and contractility, vasodilation of peripheral vasculature.
Indication :
- Mild or transient episodes of heart block that do not require electric shock or pacemaker therapy
- Serious episodes of heart block
- Adams-Stokes attacks (except when caused by ventricular tachycardia or fibrillation)
- Cardiac arrest until electric shock or pacemaker therapy is available
- Bronchospasm during anaesthesia;
- Adjunct to fluid and electrolyte replacement therapy and other drugs and procedures in the treatment of hypovolemic or septic shock and low cardiac output states
- Off-Label:
- Bradycardia
- Cardiogenic shock
- Provocation during tilt table testing for syncope
- Provocation of ventricular arrhythmias in suspected arrhythmogenic right ventricular cardiomyopathy
- Short QT-syndrome and ventricular tachycardia/ventricular fibrillation storm
- Torsades de pointes
- Beta-blocker overdose
- Electrical storm associated with Brugada syndrome
- Temporary control of bradycardia in denervated heart transplant patients unresponsive to atropine
- Ventricular arrhythmias due to AV nodal block
- Bradycardia, severe; AV nodal block
Dosing :
Continuous IV infusion: 0.05 to 0.5 mcg/kg/minute; titrate to effect; doses as high as 2 mcg/kg/minute may be needed in some patients.
Adverse Effect :
Adams-Stokes syndrome, angina pectoris, flushing, hypertension, hypotension, pallor, palpitations, paradoxical bradycardia (with tilt table testing), tachyarrhythmia, ventricular arrhythmia, ventricular premature contractions, dizziness, headache, nervousness, restlessness, seizure, hypokalemia, increased serum glucose, tremor, weakness, dyspnea, pulmonary edema, blurred vision.
Interaction :
COMT Inhibitors: May decrease the metabolism of COMT Substrates.
Linezolid: May enhance the hypertensive effect of Sympathomimetics.
QTc-Prolonging Agents: QTc-Prolonging Agents may enhance the QTc-prolonging effect of QTc-Prolonging Agents.
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics.
Theophylline Derivatives: Isoproterenol may decrease the serum concentration of Theophylline Derivatives.
Hepatic Dose :
No dose adjustments are recommended.