Parenteral Manual

Isoproterenol HCl

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
ISUPREL®
Classification: 
Sympathomimetic
Original Date: 
August 2005
Revised Date: 
December 2019
Indications: 
  • Injectable form primarily used in treatment and prevention of:
  1. Adams-Stokes syndrome - A-V heart block 
  2. Cardiac arrest       
  3. Ventricular arrhythmias
  4. Laryngospasm during anesthesia   
  5. Carotid sinus hypersensitivity
  6. Adjunctive therapy in shock
  7. Asthma/COPD
Reconstitution and Stability: 
  • Protect from light, air or heat                                                                   
  • DO NOT use discoloured or precipitated solutions
  • Diluted solutions stable 24 hrs in the fridge
Compatibility: 

- Solutions Compatible: dextrose up to D10W, NS, dextrose-saline combinations, ringer's solution, ringer's lactate

- Additives/Above Cassette Compatible: KCl (up to 40 mmol/L)

- Y-site Compatible: heparin, TPN (amino acids/dextrose)

- Incompatible: aminophylline, furosemide, sodium bicarbonate

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct YES, cardiac monitoring
Usual dilution: 10 microgram/mL
Infusion time: 5 minutes   
IV Intermittent Infusion NO
IV Continuous Infusion YES, cardiac monitoring
Usual dilution: 10 microgram/mL
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric: 

  • 0.05-2 microgram/kg/minute IV infusion

Adult:       

  • 2-20 microgram/minute IV infusion
Potential hazards of parenteral administration: 
  • Tachycardia, cardiac arrhythmias, hypotension, hypertension, chest pain, palpitations
  • Nausea, vomiting, headache, flushing
  • Tremor, weakness, restlessness, anxiety
Notes: 
  • ECG monitoring during infusion is required. 
  • Adequate oxygenation and fluid status should be maintained during infusion to minimize risk of ventricular arrhythmias and myocardial ischemia
  • Caution in patients with hyperthyroidism, diabetes mellitus or renal disease
  • Contraindicated in angina, preexisting cardiac arrhythmias, tachycardia or A-V block caused by cardiac glycoside intoxication, narrow-angle glaucoma
  • Decrease rate of infusion as necessary, ventricular rate should not exceed 60-80 beats/minute
  • Monitor heart rate, BP, RR, arterial blood gases, central venous pressure
  • When discontinuing an isoproterenol continuous infusion used for bronchodilation, the infusion must be gradually tapered over a 24-48 hr period to prevent rebound bronchospasm.

 

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