What is the effect of Isoproterenol (Isoprenaline)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 21, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Isoproterenol should be used with caution in patients with asymptomatic sinus bradycardia, as it may help differentiate those with inadequate chronotropic reserves who may require preventive pacemaker implantations, as shown in a study published in Europace in 2008 1.

Key Points to Consider

  • Isoproterenol is a non-selective beta-adrenergic agonist medication primarily used in emergency situations to treat bradycardia, heart block, and occasionally bronchospasm.
  • The typical adult dosage ranges from 2-10 mcg/min as an intravenous infusion, titrated according to heart rate response, as noted in various studies 1, 2, 3.
  • For pediatric patients, the starting dose is usually 0.05-0.1 mcg/kg/min.
  • Isoproterenol works by stimulating both beta-1 receptors in the heart (increasing heart rate and contractility) and beta-2 receptors in the lungs (causing bronchodilation).
  • Important considerations when administering isoproterenol include continuous cardiac monitoring, blood pressure monitoring, and awareness of potential side effects such as tachycardia, arrhythmias, hypotension, and tremors.
  • This medication should be used cautiously in patients with coronary artery disease, as it increases myocardial oxygen demand, as highlighted in a study published in the Journal of Clinical Pharmacology in 1976 2.
  • Isoproterenol has largely been replaced by more selective agents in many clinical scenarios but remains valuable in specific situations like temporary management of symptomatic bradycardia while awaiting pacemaker placement, as shown in a study published in the Journal of Interventional Cardiac Electrophysiology in 2001 4.

Clinical Use and Side Effects

  • Isoproterenol may be used to evaluate chronotropic reserve in patients with asymptomatic sinus bradycardia, as demonstrated in a study published in Europace in 2008 1.
  • The medication has been compared to other bronchodilators, such as ipratropium bromide, in terms of its effectiveness and side effects, as noted in a study published in the Journal of Clinical Pharmacology in 1976 2.
  • Isoproterenol has been shown to have a more pronounced effect on antegrade slow pathway conduction compared to atropine, as highlighted in a study published in the Journal of Interventional Cardiac Electrophysiology in 2001 4.
  • The medication should be used with caution in patients with certain medical conditions, such as coronary artery disease, and should be monitored closely for potential side effects, as emphasized in various studies 1, 2, 3, 4.

References

Research

Consecutive administration of atropine and isoproterenol for the evaluation of asymptomatic sinus bradycardia.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2008

Research

Differential effects of atropine and isoproterenol on inducibility of atrioventricular nodal reentrant tachycardia.

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2001

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.