Isoproterenol

General

• Type: Beta agonist; Antiarrhythmics
• Dosage Forms: IV or IM injection
• Common Trade Names: Isoprenaline, Isuprel

Adult Dosing

• Loading dose: 0.02-0.06 mg IV, followed by infusion
  • 2-20 mcg/min IV infusion
  • Titrate to HR and BP
• Alternatively, bolus 0.02-0.06 mg IV, then 0.01-0.2 mg IV PRN

Pediatric Dosing

• No well controlled studies for appropriate dosing
• AHA recommends initial infusion of 0.1 mcg/kg/min, with titrated range usually 0.1-1 mcg/kg/min

Special Populations

• Pregnancy Rating: C
• Lactation risk: Unknown
• Renal Dosing - undefined
• Hepatic Dosing - undefined

Indications

• Refractory torsades
• Refractory symptomatic bradycardia
• Refractory electrical storm
• Brugada syndrome

Contraindications

• Allergy to class/drug

Adverse Reactions

• Dramatic increase in O2 demand
• V-tach (use lowest dose possible)

Pharmacology

• Half-life: 2-10 min
• Metabolism: liver, CYP450
• Excretion: urine primarily
• Mechanism of Action: Beta adrenergic agonist

Kinetics

• Onset of action = 1-5 min
• Duration of action = 1-2 hr

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Electrical storm	2mcg/min IV infusion, titrate to HR 90-100	Torsades or Brugada syndrome	IV	Adult
Polymorphic ventricular tachycardia	2-8mcg/min IV infusion	Torsades de pointes	IV	Adult
Torsades de pointes	2-8mcg/min	Increases HR/AV conduction; target HR >90 bpm	IV	Adult

See Also

• Antiarrhythmics