1 vial

$5.40

  • Bradycardia

Note: current international guidelines do not recommend isoprenaline as the first line agent to treat any condition.

IV:
200mcg isoprenaline in 1ml and 1mg in 5ml (1:5000) vials
For IV infusion, add 1mg to 50ml of compatible IV fluid and administer at 0-60ml/hr (0-20mcg/min)
Compatible with the following IV fluids:
Normal saline Glucose and sodium chloride 5% Glucose Hartmanns
Refrigerate. Do not freeze. Protect from light and air.
Discard any diluted fluid not used within 24 hours of preparation
Do not use solution if pinkish to brown in colour or contains precipitate


ADULT DOSE

IV:
Usual dosage is 0.5mcg/min to 5mcg/min although doses of 20mcg/min or greater have been used. For bolus dosing, can dilute 200mcg in 20ml and administer 1ml bolus.

PAEDIATRIC DOSE

IV infusion:
300mcg/kg in 50ml of compatible IV fluid. Commence infusion at 0.1mcg/kg/min (1ml/hr) and titrate to effect.

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY
Dose as in normal renal function

Isoproterenol hydrochloride is a synthetic sympathomimetic amine that is structurally related to epinephrine but acts almost exclusively on beta receptors.

CONTRAINDICATIONS

  • Heart block caused by digitalis intoxication

  • Known hypersensitivity to isoprenaline


WARNINGS
Potential for worsening of cardiac function
Isoprenaline, by increasing myocardial oxygen requirements while decreasing effective coronary perfusion, may have a deleterious effect on the injured or failing heart.

Worsening of heart block
In a few patients, presumably with organic disease of the AV node and its branches, isoprenaline has paradoxically been reported to worsen heart block or to precipitate Adams-Stokes attacks during normal sinus rhythm or transient heart block.
Contains sulfite
Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people.

PRECAUTIONS
General
Isoprenaline should generally be started at the lowest recommended dose. This may be gradually increased if necessary while carefully monitoring the patient. Doses sufficient to increase the heart rate to more than 130 beats per minute may increase the likelihood of inducing ventricular arrhythmias. Such increases in heart rate will also tend to increase cardiac work and oxygen requirements which may adversely affect the failing heart or the heart with a significant degree of arteriosclerosis.
Particular caution is necessary in administering isoprenaline to patients with coronary artery disease, coronary insufficiency, diabetes, hyperthyroidism, and sensitivity to sympathomimetic amines.

Laboratory Tests:
No tests in addition to routine ICU tests are required.

Drug/Laboratory Test Interactions
None noted.

Isoprenaline and adrenalin should not be administered simultaneously because both drugs are direct cardiac stimulants and their combined effects may induce serious arrhythmias.
Beta receptor blocking agents and isoprenaline inhibit the effects of each other.

CNS:
Nervousness, headache, dizziness.
Cardiovascular:
Tachycardia, palpitations, angina, Adams-Stokes attacks, pulmonary oedema, hypertension, hypotension, ventricular arrhythmias, tachyarrhythmias.
Other:
Flushing of the skin, sweating, mild tremors, weakness

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