Chris.Rishel at 01:31, 11 January 2024

2024-01-11T01:31:02Z

← Older revision		Revision as of 18:31, 10 January 2024
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	===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===		===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===

	*Poor substrate for MAO and not taken up by neurons to the same extent as epinephrine and ~~norepinephine~~, leading to a longer duration of action		*Poor substrate for MAO and not taken up by neurons to the same extent as [[epinephrine]] and [[norepinephrine]], leading to a longer duration of action
	*Metabolized in the liver and other tissues by catechol-O-methyltransferase (COMT) to the 3-O-methyl isoproterenol metabolite, which is subsequently conjugated with sulfate		*Metabolized in the liver and other tissues by catechol-O-methyltransferase (COMT) to the 3-O-methyl isoproterenol metabolite, which is subsequently conjugated with sulfate
	*Excretion occurs via the urine		*Excretion occurs via the urine

Chris.Rishel: Added links, some formatting

2024-01-11T01:27:12Z

Added links, some formatting

← Older revision		Revision as of 18:27, 10 January 2024
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	}}		}}

	Isoprenaline (also known as ~~isopreterenol~~) is a direct-acting synthetic catecholamine. It has agonist activity at both beta-1 and beta-2 adrenergic receptors. Its approved uses are in the treatment of AV block and cardiac arrest secondary to heart block, when pacemaker therapy is not available or ineffective. However, it is also used clinically in the treatment of symptomatic bradycardia, bronchospasm, shock, arrhythmia secondary to conduction abnormalities, and ~~intraprocedurally~~ to induce arrhythmia or syncope.		'''Isoprenaline''' (also known as '''isoproterenol''') is a direct-acting synthetic catecholamine. It has agonist activity at both beta-1 and beta-2 adrenergic receptors. Its approved uses are in the treatment of AV block and cardiac arrest secondary to heart block, when pacemaker therapy is not available or ineffective. However, it is also used clinically in the treatment of symptomatic bradycardia, bronchospasm, shock, arrhythmia secondary to conduction abnormalities, and to induce arrhythmia or syncope.

	==Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. -->==		==Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. -->==
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	*Short QT syndrome		*Short QT syndrome
	*Torsades de pointes		*Torsades de pointes
	*Electrical storm in patients with Brugada syndrome		*Electrical storm in patients with [[Brugada syndrome]]

	==Contraindications<!-- List contraindications and precautions for use of the drug. -->==		==Contraindications<!-- List contraindications and precautions for use of the drug. -->==
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	*Digitalis toxicity-induced AV block		*Digitalis toxicity-induced AV block
	*Tachycardia		*Tachycardia
	*Pheochromocytoma		*[[Pheochromocytoma]]

	===Precautions<!-- List precautions for use of the drug. If none, this section may be removed. -->===		===Precautions<!-- List precautions for use of the drug. If none, this section may be removed. -->===

	*Diabetes mellitus, as it induces glycogenolysis and insulin resistance		*Diabetes mellitus, as it induces glycogenolysis and insulin resistance
	*Hyperthyroidism, as it can induce thyroid storm<ref>{{Citation\|last=Cannon\|first=Ayana\|title=Isoproterenol (Isuprel, Medihaler-ISO)\|date=2011\|url=http://dx.doi.org/10.1016/b978-1-4377-1720-4.00535-5\|work=Essence of Anesthesia Practice\|pages=613\|publisher=Elsevier\|access-date=2024-01-09\|last2=Bernstein\|first2=Wendy K.}}</ref>		*[[Hyperthyroidism]], as it can induce thyroid storm<ref>{{Citation\|last=Cannon\|first=Ayana\|title=Isoproterenol (Isuprel, Medihaler-ISO)\|date=2011\|url=http://dx.doi.org/10.1016/b978-1-4377-1720-4.00535-5\|work=Essence of Anesthesia Practice\|pages=613\|publisher=Elsevier\|access-date=2024-01-09\|last2=Bernstein\|first2=Wendy K.}}</ref>
	*Children with refractory asthma, as its use in this population can result in clinical deterioration, myocardial necrosis, congestive heart failure, and death<ref>{{Cite journal\|last=Boniol\|first=Scott\|last2=Slatkin\|first2=Neal E.\|last3=Stambler\|first3=Nancy\|last4=Israel\|first4=Robert J.\|date=2021-05-20\|title=Rescue-free laxation response with methylnaltrexone treatment in cancer patients with opioid-induced constipation: The impact of baseline ECOG status.\|url=http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e24083\|journal=Journal of Clinical Oncology\|volume=39\|issue=15_suppl\|pages=e24083–e24083\|doi=10.1200/jco.2021.39.15_suppl.e24083\|issn=0732-183X}}</ref>		*Children with refractory asthma, as its use in this population can result in clinical deterioration, myocardial necrosis, congestive heart failure, and death<ref>{{Cite journal\|last=Boniol\|first=Scott\|last2=Slatkin\|first2=Neal E.\|last3=Stambler\|first3=Nancy\|last4=Israel\|first4=Robert J.\|date=2021-05-20\|title=Rescue-free laxation response with methylnaltrexone treatment in cancer patients with opioid-induced constipation: The impact of baseline ECOG status.\|url=http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e24083\|journal=Journal of Clinical Oncology\|volume=39\|issue=15_suppl\|pages=e24083–e24083\|doi=10.1200/jco.2021.39.15_suppl.e24083\|issn=0732-183X}}</ref>
	*Recent myocardial infarction, ischemic heart disease		*Recent myocardial infarction, ischemic heart disease
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	====Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. -->====		====Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. -->====
	Isoprenaline is a potent nonselective beta agonist. Upon binding beta-1 adrenergic receptors, it increases intracellular calcium in cardiac myocytes, with positive ~~ionoptropic~~, lusitropic, chronotropic, and dromotropic effects. Beta-1 activation also activates the RAAS system in the kidney.<ref>{{Cite journal\|last=Biazi\|first=Giuliana R.\|last2=Frasson\|first2=Isabele G.\|last3=Miksza\|first3=Daniele R.\|last4=de Morais\|first4=Hely\|last5=de Fatima Silva\|first5=Flaviane\|last6=Bertolini\|first6=Gisele L.\|last7=de Souza\|first7=Helenir M.\|date=2018-05-15\|title=Decreased hepatic response to glucagon, adrenergic agonists, and cAMP in glycogenolysis, gluconeogenesis, and glycolysis in tumor‐bearing rats\|url=http://dx.doi.org/10.1002/jcb.27027\|journal=Journal of Cellular Biochemistry\|volume=119\|issue=9\|pages=7300–7309\|doi=10.1002/jcb.27027\|issn=0730-2312}}</ref> Upon binding beta-2 adrenergic receptors, it increases intracellular cAMP and PKA, inactivating myosin light chain kinase. Thus, agonism of these beta-2 receptors results in the relaxation of smooth muscle, peripheral vasodilation, bronchial dilation, and uterine smooth muscle relaxation. Isoprenaline also induces hepatic glycogenolysis and release of glucagon from the pancreas via beta-2 adrenergic activity.<ref>{{Cite journal\|last=Matera\|first=Maria Gabriella\|last2=Page\|first2=Clive\|last3=Rinaldi\|first3=Barbara\|date=2018-06\|title=β2-Adrenoceptor signalling bias in asthma and COPD and the potential impact on the comorbidities associated with these diseases\|url=http://dx.doi.org/10.1016/j.coph.2018.04.012\|journal=Current Opinion in Pharmacology\|volume=40\|pages=142–146\|doi=10.1016/j.coph.2018.04.012\|issn=1471-4892}}</ref>		Isoprenaline is a potent nonselective beta agonist. Upon binding beta-1 adrenergic receptors, it increases intracellular calcium in cardiac myocytes, with positive inotropic, lusitropic, chronotropic, and dromotropic effects. Beta-1 activation also activates the RAAS system in the kidney.<ref>{{Cite journal\|last=Biazi\|first=Giuliana R.\|last2=Frasson\|first2=Isabele G.\|last3=Miksza\|first3=Daniele R.\|last4=de Morais\|first4=Hely\|last5=de Fatima Silva\|first5=Flaviane\|last6=Bertolini\|first6=Gisele L.\|last7=de Souza\|first7=Helenir M.\|date=2018-05-15\|title=Decreased hepatic response to glucagon, adrenergic agonists, and cAMP in glycogenolysis, gluconeogenesis, and glycolysis in tumor‐bearing rats\|url=http://dx.doi.org/10.1002/jcb.27027\|journal=Journal of Cellular Biochemistry\|volume=119\|issue=9\|pages=7300–7309\|doi=10.1002/jcb.27027\|issn=0730-2312}}</ref> Upon binding beta-2 adrenergic receptors, it increases intracellular cAMP and PKA, inactivating myosin light chain kinase. Thus, agonism of these beta-2 receptors results in the relaxation of smooth muscle, peripheral vasodilation, bronchial dilation, and uterine smooth muscle relaxation. Isoprenaline also induces hepatic glycogenolysis and release of glucagon from the pancreas via beta-2 adrenergic activity.<ref>{{Cite journal\|last=Matera\|first=Maria Gabriella\|last2=Page\|first2=Clive\|last3=Rinaldi\|first3=Barbara\|date=2018-06\|title=β2-Adrenoceptor signalling bias in asthma and COPD and the potential impact on the comorbidities associated with these diseases\|url=http://dx.doi.org/10.1016/j.coph.2018.04.012\|journal=Current Opinion in Pharmacology\|volume=40\|pages=142–146\|doi=10.1016/j.coph.2018.04.012\|issn=1471-4892}}</ref>

	====Adverse effects<!-- Describe any potential adverse effects of the drug. -->====		====Adverse effects<!-- Describe any potential adverse effects of the drug. -->====
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	===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===		===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===

	*Poor substrate for MAO, not taken up by neurons to the same extent as epinephrine and norepinephine~~. This~~, duration of action ~~of isoprenaline is longer than epinephrine.~~		*Poor substrate for MAO and not taken up by neurons to the same extent as epinephrine and norepinephine, leading to a longer duration of action
	*~~Instead, it is metabolized~~ in the liver and other tissues by catechol-O-methyltransferase (COMT) to the 3-O-methyl isoproterenol metabolite, which is subsequently conjugated with sulfate		*Metabolized in the liver and other tissues by catechol-O-methyltransferase (COMT) to the 3-O-methyl isoproterenol metabolite, which is subsequently conjugated with sulfate
	*Excretion occurs via the urine		*Excretion occurs via the urine
	*Onset of action: immediate		*Onset of action: immediate
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	==Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. -->==		==Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. -->==
	Isoprenaline hydrochloride ~~(also called isoproterenol hydrochloride)~~ is 3,4-Dihydroxy-alpha- (isopropylamino) methyl benzyl alcohol hydrochloride, a synthetic sympathomimetic amine that is structurally related to epinephrine but acts almost exclusively on beta adrenergic receptors.		Isoprenaline hydrochloride is 3,4-Dihydroxy-alpha-(isopropylamino) methyl benzyl alcohol hydrochloride, a synthetic sympathomimetic amine that is structurally related to epinephrine but acts almost exclusively on beta adrenergic receptors.

	==History<!-- Describe the historical development of the drug. -->==		==History<!-- Describe the historical development of the drug. -->==

Mccarta: Wrote general information, uses, contraindications, pharmacodynamics sections

2024-01-09T20:06:39Z

Wrote general information, uses, contraindications, pharmacodynamics sections

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Provide a brief summary of this drug here.

== Uses ==

== Contraindications ==

=== Absolute contraindications ===

=== Precautions ===

== Pharmacology ==

=== Pharmacodynamics ===

==== Mechanism of action ====

==== Adverse effects ====

=== Pharmacokinetics ===

== Chemistry and formulation ==

== History ==

== References ==

[[Category:Drug reference]]

Isoprenaline - Revision history

Chris.Rishel at 01:31, 11 January 2024

Chris.Rishel: Added links, some formatting

Mccarta: Wrote general information, uses, contraindications, pharmacodynamics sections

Oliviamsutton: Created page with "{{Infobox drug reference | trade_names = | drug_class = | drug_class_color = | uses = | contraindications = | routes = | dosage = }} Provide a brief summary of this dr..."