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isoproterenol inhalation

Pronunciation

Generic Name: isoproterenol inhalation (eye so proe TER e nole)
Brand Name: Isuprel Mistometer, Isuprel HCl, Medihaler-Iso

What is isoproterenol inhalation?

Isoproterenol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.

Isoproterenol inhalation is used to treat conditions such as asthma, bronchitis, and emphysema.

Isoproterenol inhalation may also be used for conditions other than those listed in this medication guide.

What is the most important information I should know about isoproterenol inhalation?

It is important to use the isoproterenol inhaler properly, so that the medicine gets into the lungs. Your doctor may want you to use a spacer with the inhaler. Talk to your doctor about proper inhaler use.

Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.

What should I discuss with my healthcare provider before using isoproterenol inhalation?

Before using this medication, tell your doctor if you have

  • heart disease or high blood pressure;

  • epilepsy or a seizure disorder;

  • diabetes;

  • an overactive thyroid (hyperthyroidism); or

  • liver or kidney disease.

You may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Isoproterenol inhalation is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether isoproterenol passes into breast milk. Do not use isoproterenol inhalation without first talking to your doctor if you are breast-feeding a baby.

How should I use isoproterenol inhalation?

Use isoproterenol inhalation exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

To use the inhaler:

  • Shake the inhaler several times and uncap the mouthpiece. Breathe out fully. Put the mouthpiece of the inhaler or spacer into your mouth. Be sure the mouthpiece is above the tongue and past the teeth. Alternatively, place the inhaler mouthpiece (not with spacer attached) several inches in front of your open mouth, if directed to do so by your doctor. Take a deep, slow breath as you push down on the canister. Hold your breath for 10 seconds, then exhale slowly.

  • If you take more than one dose at a time, wait for at least 1 full minute, then repeat the procedure.

  • Keep the inhaler clean and dry. Keep the mouthpiece capped to avoid getting dirt inside it. Clean the inhaler once a day by removing the canister and immersing the mouthpiece in warm water. Allow the parts to dry, then reassemble the inhaler.

To use the solution for nebulization:

  • Measure the correct amount of medication with the dropper provided or select the prescribed number of ampules. Transfer the liquid into the medication chamber of the nebulizer. If the medication has a dropper, do not allow the dropper to touch any surface including the hands or the chamber of the nebulizer. Dilute the medication with normal saline if prescribed by your doctor.

  • Attach the mouthpiece or face mask to the drug chamber. Then, attach the drug chamber to the compressor. Sit upright, in a comfortable position, and put the mouthpiece into the mouth or put the face mask on, covering the nose and mouth. Breathe slowly and evenly until all of the medicine has been inhaled (usually 5 to 15 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.

  • Clean the nebulizer after a treatment as directed by the manufacturer.

If you also use a steroid inhaler, use the isoproterenol inhaler or nebulization solution first to open up the airways, then use the steroid inhaler as directed.

It is important to use the isoproterenol inhaler properly, so that the medicine gets into the lungs. Your doctor may want you to use a spacer with the inhaler. Talk to your doctor about proper inhaler use.

Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.

Carry the inhaler with you at all times in case of emergencies. Store the solution for nebulization at room temperature. Get a refill before you run out of medicine and before going on vacation.

What happens if I miss a dose?

Use the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and use the next one as directed. Do not use a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of an isoproterenol inhalation overdose may include angina or chest pain, irregular heartbeats or a fluttering heart, seizures, tremor, weakness, headache, nausea, and vomiting.

What should I avoid while using isoproterenol inhalation?

Avoid situations that may trigger an asthma attack such as exercising in cold, dry air; smoking; breathing in dust; and exposure to allergens such as pet fur.

Isoproterenol inhalation side effects

If you experience any of the following serious side effects, stop using isoproterenol inhalation and seek emergency medical attention or contact your doctor immediately:

  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or

  • chest pain or an irregular heartbeat.

Other, less serious side effects may be more likely to occur. Continue to use isoproterenol inhalation and talk to your doctor if you experience

  • headache, dizziness, lightheadedness, or insomnia;

  • tremor or nervousness;

  • sweating;

  • nausea, vomiting, or diarrhea; or

  • dry mouth.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Isoproterenol inhalation Dosing Information

Usual Adult Dose for Asthma -- Acute:

Hand-bulb nebulizer: The 1:200 solution administered in a dose of 5 to 15 deep inhalations. In adults, the 1:100 solution in a dose of 3 to 7 deep inhalations may be used if a stronger solution is desired. If after 5 to 10 minutes inadequate relief is observed, these doses may be repeated one more time. If the acute attack recurs, treatments may be repeated up to 5 times daily if necessary.
Inhalation Aerosol: Inhale one activation and wait one full minute before considering a second inhalation. A treatment may be repeated up to 5 times daily if necessary.

Usual Adult Dose for Chronic Obstructive Pulmonary Disease -- Acute:

Hand-bulb nebulizer: The 1:200 solution administered in a dose of 5 to 15 deep inhalations. In adults, the 1:100 solution in a dose of 3 to 7 deep inhalations may be used if a stronger solution is desired. If after 5 to 10 minutes inadequate relief is observed, these doses may be repeated one more time. If the acute attack recurs, treatments may be repeated up to 5 times daily if necessary.
Nebulization By Compressed Air Or Oxygen--A method often used in patients with severe COPD is to deliver the isoproterenol mist in more dilute form over a longer period of time. The purpose is to achieve progressively deeper bronchodilation and thus insure that the mist achieves maximum penetration of the finer bronchioles. In this method, 0.5 mL of a 1:200 solution of isoproterenol is diluted to 2 to 2.5 mL with water or saline to achieve a concentration of 1:800 to 1:1000. If desired, 0.25 mL of the 1:100 solution may be similarly diluted to achieve the same concentration. The diluted solution is placed in a nebulizer connected to either a source of compressed air or oxygen. The flow rate is regulated so that the diluted solution of isoproterenol will be delivered over approximately 10 to 20 minutes. A treatment may be repeated up to 5 times daily if necessary. Although the total delivered dose of isoproterenol is somewhat higher than with the treatment regimen employing the hand-bulb nebulizer, patients usually tolerate it well because of the greater dilution and longer application-time factors.
Intermittent positive pressure breathing (IPPB): 0.5 mL of a 1:200 solution diluted to 2 to 2.5 mL with water or isotonic saline. Deliver over 15 to 20 minutes. May repeat up to 5 times daily.
Inhalation Aerosol: Inhale one or two activations. Repeat at no less than 3 to 5 hour intervals (6 to 8 times daily).

Usual Adult Dose for Bronchospasm During Anesthesia:

IV Bolus: Dilute 1 mL (0.2 mg) to 10 mL with Sodium Chloride, or 5% Dextrose Injection and administer 0.01 to 0.02 mg (0.5 to 1 mL of diluted solution).
The initial dose may be repeated when necessary.

Usual Adult Dose for Shock:

IV infusion: Dilute 5 mL (1 mg) in 500 mL of 5% Dextrose Injection and administer 0.5 to 5 mcg/min (0.25 to 2.5 mL of diluted solution).
Concentrations up to 10 times greater have been used when limitation of volume is essential. Rates over 30 mcg/min have been used in advanced stages of shock. The rate of infusion should be adjusted on the basis of heart rate, CVP, systemic blood pressure, and urine flow. If the heart rate exceeds 110 beats per minute, it may be advisable to decrease
or temporarily discontinue the infusion.

Usual Adult Dose for Adams-Stokes Syndrome:

IV Bolus: Dilute 1 mL (0.2 mg) to 10 mL with Sodium Chloride, or 5% Dextrose Injection and administer 0.02 to 0.06 mg (1-3 mL of diluted solution).
Subsequent dose range is 0.01 to 0.2 mg (0.5 to 10 mL of diluted solution).
IV infusion: Dilute 10 mL (2 mg) in 500 mL of 5% Dextrose Injection and administer at 5 mcg/min. (1.25 mL of diluted solution/min).
Intramuscular: Use 1:5000 solution undiluted and administer 0.2 mg (1 mL).
Subsequent dose range is 0.02 to 1 mg (0.1 to 5 mL)
Subcutaneous: Use 1:5000 solution undiluted and administer 0.2 mg (1 mL).
Subsequent dose range is 0.15 to 0.2 mg (0.75 to 1 mL).
Intracardiac: Use 1:5000 solution undiluted and administer 0.02 mg (0.1 mL)

Usual Adult Dose for AV Heart Block:

IV Bolus: Dilute 1 mL (0.2 mg) to 10 mL with Sodium Chloride, or 5% Dextrose Injection and administer 0.02 to 0.06 mg (1-3 mL of diluted solution).
Subsequent dose range is 0.01 to 0.2 mg (0.5 to 10 mL of diluted solution).
IV infusion: Dilute 10 mL (2 mg) in 500 mL of 5% Dextrose Injection and administer at 5 mcg/min. (1.25 mL of diluted solution/min).
Intramuscular: Use 1:5000 solution undiluted and administer 0.2 mg (1 mL).
Subsequent dose range is 0.02 to 1 mg (0.1 to 5 mL)
Subcutaneous: Use 1:5000 solution undiluted and administer 0.2 mg (1 mL).
Subsequent dose range is 0.15 to 0.2 mg (0.75 to 1 mL).
Intracardiac: Use 1:5000 solution undiluted and administer 0.02 mg (0.1 mL)

Usual Pediatric Dose for Asthma -- Acute:

Hand-bulb nebulizer: The 1:200 solution administered in a dose of 5 to 15 deep inhalations. Do not use more than 0.25 mL of the 1:200 solution for each of the 10 to 15 minute programmed treatments. If after 5 to 10 minutes inadequate relief is observed, these doses may be repeated one more time. If the acute attack recurs, treatments may be repeated up to 5 times daily if necessary.
Inhalation Aerosol: Inhale one activation and wait one full minute before considering a second inhalation. A treatment may be repeated up to 5 times daily if necessary.

Usual Pediatric Dose for Cardiac Arrhythmia:

Neonates, infants, and children: 0.05 to 2 mcg/kg/min.

What other drugs will affect isoproterenol?

Before using this medication, tell your doctor if you are taking any of the following medicines:

  • a beta-blocker such as atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), propranolol (Inderal), and others;

  • a tricyclic antidepressant such as amitriptyline (Elavil), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), and others;

  • a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);

  • another inhaled bronchodilator; or

  • caffeine, diet pills, or decongestants.

You may not be able to use ipratropium inhalation, or you may require a dosage adjustment or special monitoring during treatment.

Drugs other than those listed here may also interact with isoproterenol inhalation or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

  • Your pharmacist has additional information about isoproterenol written for health professionals that you may read.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.04. Revision Date: 2010-12-15, 5:01:39 PM.

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