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Isoproterenol/Isuprel, Medihaler Iso

- See: Inotropic Agents 
- Discussion:

- use of this med is limited to temporary control of significant Bradycardia that is refractory to atropine; 
- is the only one of the major inotropes which can decrease pulmonary vascular resistance; 
- this is useful in patients w/ pulmonary HTN (esp. mitral valve patients) & patients w/ acute Right Heart Failure; 
- Precautions: 
- it is not indicated in the treatment of electromechanical dissociation;

- it is extremely arrhythmogenic, causing Ventricular arrhythmia's w/ even moderate dosing; 
- avoid excessive HR especially with acute MI
- vasodilation with decrease in blood pressure; 
- contraindicated with Tachycardia, pulse >130 may induce ventricular arrhythmias; 
- Dosage: 
- infusion is prepared by adding 1-2 mg of isoproterenol to 250-500 ml of D5W and administering at 1-20 ug/min and titrate to HR;

- may begin therapy with small ?(0.2-0.5mg) IV dose; 
- then begin IV infusion; 
- Cardiac arrest and Cardiac Dysrhythmias: 
- Dilute .2mg (1ml of 1:5000 sol) to 10ml with .9% NaCl of D5W, and inject IV 0.02-0.06mg (1-3ml); 
- Shock: 1-4ug/min IV infusion, titrateto effect, or better try: