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isoproterenol
• INDICATIONS
• ADVERSE EFFECTS
– asystole
– 3° AV block
– torsades de pointes (TdP)
• CONTRAINDICATIONS
– ventricular arrhythmias (except
TdP)
– ACS
Dose: 2 –10  / min,
– sinus tachycardia
– ventricular arrhythmias
– myocardial ischemia
• KEEP WATCH
–
–
–
–
monitor BP
monitor EKG
signs of myocardial ischemia
chest pain
0,02 – 0,1 γ/Kg/min, IV infusion in pump
Isoproterenol
generic name: isoproterenol
brand name (Italy): Isuprel
available forms (Italy): One 1-ml vial of Isuprel contains 0.2 mg of isoproterenol
Administration: continuous IV infusion
Dilute 5 vials of Isuprel (total: 1 mg of isoprenaline) in 50 ml  1000 gamma in 50 mL 
one milliliter of this solution will contain 200 gamma of isoproterenol.
Infuse at 2 to 10 gamma / minute and titrate to desired effect (adequate heart rate). The
drug is used for temporary treatment of hemodynamically significant bradyarrhythmias,
until pacemaker therapy can be initiated.
Example:
If the starting dose is 2 mcg/min  120 gamma/hour.
Considering that 1 mL of solution contains 200 gamma  120 gamma will be in 0,6 mL of
solution and consequently  the infusion rate should be set at 0.6 mL/hour
Important:
a) dilute with distilled water, D5W (5% dextrose in water), or normal saline
b) do not mix with other drugs
c) co-administration with epinephrine or other adrenergic drugs can cause additive
effects
d) avoid bolus administration
e) dilute before administering
f) if cardiac arrhythmias develop during administration, give selective β-blocker
(atenolol) IV